ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

of 143 /143
ARGYLL & BUTE CHP COMMITTEE MEETING Wednesday 21 August 2013 Lecture Room, Oban Community Fire Station 12.30pm – Lunch 1pm – Committee Meeting 1. Chairman’s Welcome Robin Creelman 2. Apologies Robin Creelman 3. Conflicts of Interest Robin Creelman 4. Minutes from Previous Meeting Robin Creelman 4.1a Draft Minute of 19 June 2013 (attached) 5. Matters Arising 6. NHS Highland Organisational Issues 6.1 Report of Highland NHS Board of 13-09-13 (verbal) Robin Creelman 6.2 Director of Operations Report (to follow) Derek Leslie 6.3 Feedback from Annual Review (verbal) Derek Leslie 7. Clinical Governance 7.1 Clinical Governance & Risk Management Report (attached) Pat Tyrrell 7.2 Infection Control Report (attached) Pat Tyrrell 7.3 Community Planning Partnership & Single Outcome Agreement Update (attached) Elaine Garman 10.30am - 12.30pm – Committee Members Development Session Early Years Collaborative – Pat Tyrrell Dementia – Pat Tyrrell Children’s Services Inspection Report – Pat Tyrrell

Embed Size (px)

Transcript of ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

Page 1: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

ARGYLL & BUTE CHP COMMITTEE MEETING

Wednesday 21 August 2013

Lecture Room, Oban Community Fire Station

12.30pm – Lunch

1pm – Committee Meeting

1. Chairman’s Welcome Robin Creelman 2. Apologies Robin Creelman

3. Conflicts of Interest Robin Creelman

4. Minutes from Previous Meeting Robin Creelman 4.1a Draft Minute of 19 June 2013 (attached) 5. Matters Arising 6. NHS Highland Organisational Issues

6.1 Report of Highland NHS Board of 13-09-13 (verbal) Robin Creelman 6.2 Director of Operations Report (to follow) Derek Leslie 6.3 Feedback from Annual Review (verbal) Derek Leslie

7. Clinical Governance 7.1 Clinical Governance & Risk Management Report (attached) Pat Tyrrell 7.2 Infection Control Report (attached) Pat Tyrrell 7.3 Community Planning Partnership & Single Outcome Agreement Update (attached) Elaine Garman

10.30am - 12.30pm – Committee Members Development Session

� Early Years Collaborative – Pat Tyrrell � Dementia – Pat Tyrrell � Children’s Services Inspection Report – Pat Tyrrell

Page 2: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

3.30pm : Public Session

8. Financial Governance 8.1 Finance Report (attached) George Morrison 9. Staff Governance

9.1 PDP/R and eKSF Implementation (attached) David Logue 9.2 Draft Minute of Partnership Forum Meeting of 04-07-13 (attached) David Logue

10. Partnership Working (verbal) Derek Leslie/ Duncan Martin

11. Performance Management

11.1 Delayed Discharge Update (attached) Derek Leslie

12. Mental Health Modernisation Update (attached) John Dreghorn 13 Noting

• Draft Minute of eHealth Group Meeting – 01-05-13 (attached) 14. AOCB*

15. Date, Time & Venue for Next Meeting

Wednesday 23 October 2013 at 10.30am J03-J07, Mid Argyll Community Hospital & Integrated Care Centre, Lochgilphead

* to be notified to Chairman in advance of meeting

The Committee meeting will be followed by:

Page 3: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

Argyll & Bute CHP Committee 21 August 2013 Item : 4.1

MINUTE OF MEETING OF THE ARGYLL & BUTE CHP COMMITTEE

Argyll & Bute Community Health Partnership Aros Lochgilphead Argyll PA31 8LB www.nhshighland.scot.nhs.uk/

Mid Argyll Community

Hospital & Integrated Care Centre, Lochgilphead

19 June 2013

Present Present by VC

Mr Robin Creelman, Chairman, Argyll & Bute CHP Mr Derek Leslie, Director of Operations, Argyll & Bute CHP Dr Michael Hall, Clinical Director, Argyll & Bute CHP Ms Pat Tyrrell, Lead Nurse, Argyll & Bute CHP Ms Elaine Garman, Public Health Representative, Argyll & Bute CHP Ms Mary Wilson, AHP Representative, Argyll & Bute CHP Ms Elizabeth Reilly, Area Dental Committee Representative Mr Duncan Martin, Chairman, Public Partnership Forum Mr Michael Roberts, Vice Chair, Public Partnership Forum Councillor Elaine Robertson, Argyll & Bute Council Representative

In Attendance Apologies

Mr George Morrison, Head of Finance, Argyll & Bute CHP Mr David Logue, Head of HR, Argyll & Bute CHP Mrs Sheena Clark, PA to Director of Operations - Minute Secretary Mr Stephen Whiston, Head of Planning Contracting & Performance, Argyll & Bute CHP Mr David Ritchie, Communications Manager, Argyll & Bute CHP Ms Dawn Gillies, Staffside Representative Ms Liz McMillan, Staffside Representative Cleland Sneddon, Executive Director, Community Services, Argyll & Bute Council Jim Robb, Head of Service, Adult Care, Argyll & Bute Council Councillor George Freeman, Argyll & Bute Council Representative Ms Glenn Heritage, CVO Representative

1. CHAIRMAN’S WELCOME The Chairman opened the meeting by welcoming everyone to Mid Argyll Community Hospital & Integrated Care Centre, Lochgilphead. 2. APOLOGIES Apologies for absence were noted as above. 3. CONFLICTS OF INTEREST No conflicts of interest were declared.

Page 4: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

2

4. MINUTE FROM PREVIOUS MEETING 4.1a Minute of Meeting held on 19 June 2013 The Committee: Approved the content of the Minute of the meeting on 24 April 2013. 4.1b Minute of Public Session of 24 April 2014 The Committee: Approved the content of the Minute of the Public Session on 24 April 2013. 5. MATTERS ARISING FROM PREVIOUS MEETING HELD ON 24 April 2013 Page 3 – Major Incident – Mid Argyll, Kintyre & Islay – Councillor Robertson enquired if a ‘common’ list of vulnerable people will be rolled out to each CHP locality. Mr Leslie confirmed this to be the case and that the list will be updated as required by the relevant agencies. Ms Garman stated that a key point will be to agree the criteria of a vulnerable person as the situation for those named can change day to day. Lessons learned from the incident and debriefing notes are due to be discussed at an Emergency Planning Meeting and the outcome shared across localities. 6. NHS Highland Organisational Issues 6.1 Highland NHS Board – 4 June 2013 Mr Creelman reported that Dr Bashford, Board Clinical Director praised the detail of the information provided in the CHP’s Clinical Governance and Risk Management Report to the Committee. The Committee: Noted the above comment. 6.2 Director of Operations Report Mr Leslie provided a summary of key points in the circulated report. Helensburgh & Lomond Out of Hours Nursing Service – the status quo currently remains in the provision of this service. A meeting is scheduled at end July with NHS Greater Glasgow & Clyde to discuss the proposed redesign of the out of hours nursing service for patients in the Helensburgh & Lomond area as a result of an intimation from the West Dunbartonshire CHCP of an intention to effect changes to the SLA. Primary Medical Services Information Sharing - the availability of a significant quantity of information to monitor and understand performance in primary care is being collected by the Primary Care management section of the CHP. Senior managers have been asked to reflect on the extent and value of this information so that any necessary refinements to the arrangements for information and intelligence collection

Page 5: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

3

can be agreed. The range of information and the outputs will feature at a future development session the CHP Committee. Bereavement Strategy - an action plan has been developed to assist in the delivery of bereavement care guidelines and the development of support which will comply with the “Shaping Bereavement Care – A Framework for Action CEL9 (2011). The CHP Lead AHP has been identified as the link person to take forward the action plan. Early Years Collaborative – this is a significant strategic initiative by the Scottish Government in collaboration with the Council. The need for funding (amounting to £42k) has been added to the cost pressures to be managed by the CHP in order to part fund a Project Manager and Data Manager post for the next 2 years to support the early years collaborative. Patient Management System (PMS) Update - work in relation to implementing the new PMS is progressing to plan and has been formally in operation for two months plus. The specific challenges associated with Argyll & Bute will be addressed as the implementation progresses. It was noted that improved clinical awareness and participation into the implementation of the system will be pursued. Delivery of Sustainable Remote & Rural Health & Social Care – the CHP contributed to a NHS Highland proposal submitted to the Scottish Government to test models for the delivery of sustainable remote and rural health and social care services which would have application across Scotland. Mid Argyll & Kintyre were identified as two strands to be linked into the work to be undertaken.

NHS Highland currently awaits feedback from SGHD on the draft proposal, with the final proposal to be submitted and a decision expected thereafter, with the resourcing availability for the project work still to be confirmed

Campbeltown Community Hospital Continuing Care Beds - members of the CHP management team and locality staff attended a meeting in Campbeltown hosted by the Campbeltown Community Council on Monday 13 May 2013. The two agenda items were the closure of continuing care beds in Campbeltown Community hospital and the substitute prescribing service. The meeting was attended by approx 190 people. Local staff presented information about local service developments and the bed modelling process which has been in progress for two years. In relation to closure of continuing care beds, the main concerns raised were; contingency planning for emergencies, adequate beds available for those who need them locally to avoid transfers out of the area, difficulties recruiting and retaining local staff to take on skilled carers roles, how resource release and the free space in the hospital would be utilised. Reassurance was provided that contingency plans are in place to cope with the peaks and troughs in demand for in-patient beds and that a group with public representatives has been established to identify how resource release should be used to meet local gaps in community service provision. The free space in the hospital will also be reviewed by the redesign group, to identify what local service development might be supported by the use of this additional space. Mr Leslie reaffirmed that the closed beds had not been in use. Substitute Prescribing - the community of Campbeltown voiced many concerns related to the provision of a substitute prescribing service locally. The Kintyre Substance Misuse Working Group (KSMWG) met on 13 June 2013 to review the current position.

Page 6: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

4

Building the Bridge Together - an event to consider how we can work better together to enable older people to live long, healthy and fulfilling lives in Argyll & Bute was recently held in the Corran Halls, Oban. The event was very well attended by a full range of key stakeholders with an interest and influence in reshaping care for older people who were challenged to develop a shared understanding of the ambition to reshape care for older people and contributing to defining values and behaviour to achieve this. A report on the outcome of the event will be published in due course. Argyll & Bute Hospital 150 Years Anniversary - more than 100 staff past and present gathered on 29 May to celebrate the unveiling of a special plaque by Thomas Byrne, Director of Mental Health Charity, Acumen to celebrate the 150th anniversary of the Argyll & Bute Hospital. Volunteering Awards - the annual Volunteer Awards took place in Council Chambers, Kilmory on 31 May. The event is organised annually by Argyll Voluntary Action to celebrate volunteering across Argyll and Bute and is attended by organisations, Councillors, volunteers, carers and was also attended this year by Jackie Baillie, MSP. For the second year NHS Highland have sponsored a “Health Volunteer Award” for individuals who volunteer in a health environment. This year we had two prize winners. The Committee: Noted the content of Director of Operations Report. 7. Clinical Governance 7.1 Clinical Governance & Risk Management Report Ms Tyrrell spoke to the circulated report and highlighted and summarised a number of items. Risk Management Incidents – the graphs illustrated the number of incidents reported through Datix over the past 13 months. As the information for April 2013–June 2013 was unavailable at the time of reporting, the report to the Committee in June will feature the top five incidents, with categories, details and actions undertaken. Ms Tyrrell advised that the audit scores represent compliance of evidence based practice. Mr Creelman enquired about the availability information to measure adherence to ‘surgical pause’ by surgical staff. Ms Tyrrell confirmed that this practice does take place and she will provide evidence details in future reports. Pressure Ulcer Prevention – there has been a sustained reduction in the number of incidents due to the work of staff in applying the clinical quality indicators, with no Grade 3 or 4 hospital acquired pressure ulcers reported in Argyll & Bute since the last report. A significant amount of work continues in community settings to raise awareness of patients, carers and staff in all sectors to ensure that appropriate risk management is undertaken at all times. The recruitment of an Advance Nurse – Tissue Viability should be completed by September 2013 which will provide additional capacity to undertake this work.

Page 7: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

5

Falls Prevention - as with Pressure Ulcer prevention considerable amount of work is underway to reduce the incidence of falls in both hospital and community settings. Application of evidence based interventions, in the assessment and management of risk in those likely to sustain falls, is being tested in Lorn and Islands Hospital in Oban. Some wards are showing a reduction in falls, partly due to the change in patients groups, i.e. vulnerable patients. Serious Untoward Incidents (SUI) - Since the last report there has been one SUI related to patient suicide. The formal SER meeting took place on 10 June 2013. The report and action plan is under development and will be discussed at the next Clinical Governance and Risk Management meeting. Health Improvement Scotland Adverse Event Review - HIS will be reviewing NHS Highland in relation to the Management of Adverse Events on 7 August 2013. In preparation for the review visit NHS Highland has been asked to submit details of all adverse events during the 18 month period November 2011- April 2013. A total of 28 Argyll & Bute CHP incidents have been submitted. The level of review for each of these incidents was as follows: Full Significant Event Review (SER): 17 Local Case Review 8 Significant Event Analysis (Primary Care process) 2 SER not conducted as incident addressed via HR process 1 It is understood that 4 of the total number of incidents submitted by NHSH will be selected for further scrutiny. Further details about arrangements for the review visit are awaited. Complaints Of the 11 complaints received in March/April 2013 the themes can be broadly categorised as follows, with some complaints containing more than one theme :

Care / Treatment 6 Attitude 4 Communication 3 Access 3 Confidentiality 1

Pat undertook to review the detail of the information presented to the Committee around complaints reporting and provide additional detail at the next meeting. External Review Joint Inspection of Children’s Services in Argyll and Bute - the pilot inspection in Argyll and Bute was completed in April 2013 and verbal feedback from the Joint Inspection Team was delivered to Senior Officers on 3 May 3. The findings of the inspection were very similar to our own self evaluation findings and identified a number of strengths as well as areas requiring increased focus. The timescale for delivery of the final report has been lengthened and it is now expected that this will be received in July. The Integrated Children’s Services Plan for Argyll and Bute is under development and will contain all of the actions required to address areas identified within the inspection findings. CPA Surveillance Inspection of LIH, Oban Laboratories – a follow up inspection took place in April and the laboratories retained their accreditation.

Page 8: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

6

Quality Older People in Acute Care Local inspection visits were conducted at all hospitals/wards within the CHP during May 2013. The purpose of these visits is to share learning across all sites and to ensure that there is a focus on the key priorities for improvements. A range of tools were used during the visits including national tools from HEI/HIS. Inspection included:

• environmental audits • observational audits of interactions with patients; • care planning audit; • inspection of invasive devices (peripheral vascular catheters and urinary

catheters) • interviews with staff patients and carers • mealtime observations

The inspection teams included a range of staff from the CHP (external to the site being visited). Some teams also included a non-executive and patient/public partnership representative. Ms Tyrell will update the Committee in August, detailing the outcome of the visits and of the action plan which will be developed to support improvements and shared learning. Person Centred Care To support our approach to delivering person centre care, the CHP was privileged to learn first hand about the Esther Network, a Swedish healthcare system which is widely recognised as a world leader in patient-centred care, committed to assessing their services “through patients’ eyes”. Two sessions were delivered by the Director of the Esther Network and a colleague on 10 June 2013 in Oban and Inveraray. During these sessions ways to adopt the Esther approach in Argyll and Bute were explored and with the support of the Joint Improvement Team the CHP is continuing this look at this method across the partnership as part of the Reshaping Care for Older People programme. Scottish Patient Safety Programme (SPSP) Acute Services – progress has been sustained across the range of indicators. Mental Health – is in the very early stages of implementing SPSP and a team has been identified to take the programme forward and a progress measurement will be put in place. Health & Safety Revised Health & Safety Work Programme The NHS Highland work programme for Health & Safety 2013-2015 is being revised and updated. The CHP operational plan will contain all the work streams within the corporate plan, together with areas of work to meet local concerns. The plan will be tabled at the CHP Operational Health & Safety Group in August 2013.

Page 9: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

7

Fire Safety Actions plans are being developed following the recent fire risk assessments carried out by the CHP Risk Advisor-Fire Safety. Councillor Robertson enquired about the timescale of completion of the Fire Service audits. Mr Leslie advised that there were no specific timescales due to the requirement to complete compartmentisation work and he undertook to provide a summary of the outcome of the audits at the date of the next Committee meeting. 7.2 Infection Control Report Ms Tyrrell referred to the circulated report. Staphlococcus Aureus Baceraemia (SAB) (including MRSA) There have been two cases of SAB in Lorn & Islands Hospital since the last report, one due to a contaminated blood sample taken from blood cultures and the other is been subjected to a root cause analysis to identify the cause. There is a robust process in place to look at and factor in all learning from identified cases and actions taken. Responding to an enquiry from Mr Creelman around the long term use of antibiotics at home, Ms Tyrrell advised that the CHP is currently reviewing this practice and work is currently ongoing with Community Nurse in relation to their management of patient at home. Mr Creelman asked if MRSA screening is undertaken in the CHP. Ms Tyrrell confirmed that although compliance is only required in hospital settings, screening has been rolled out CHP wide. Ms Tyrrell emphasised that any evidence of non-compliance by staff of the front line audit process needs to be highlighted to ensure effective control of the guidelines. Clostridium Difficile (CDI) Target There have been two reported cases of CDI in Argyll & Bute since the last report, one in the hospital and one in the community. Further surveillance is underway to identify the root cause of each case. Hand Hygiene Monthly audits continue to be undertaken by all clinical areas, the results displayed and any non-compliance addressed. The CHP continues to demonstrate compliance with standards and quality assurance is consistently monitored to ensure there is no complacency within any areas. Cleaning & Healthcare Environment The CHP monthly cleaning and estates audits as per the National Cleaning Services Specification demonstrated 96% compliance for domestic monitoring and 97% for estates monitoring in March/April 2013.

The Committee: Noted the content of the Clinical Governance & Risk Management Report

Page 10: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

8

Results for all Argyll and Bute Hospitals recorded that all areas achieved above 90% target for April/May 2013 and above 95% for estates issues. However three sites were below the 95% compliance for cleaning standards for May, Rothesay Victoria Hospital, Helensburgh and Islay and work to address the identified deficits has been progressed. Outbreaks/Incidents There have been no outbreaks or incidents in Argyll and Bute since the last report. 7.3 Health Improvement Ms Garman provided an update from submission of first Health Promoting Health Service (HPHS) annual report sent to Health Scotland and Scottish Government. NHS Highland has requested informal feedback with regards to the content and detail but this has not yet been forthcoming. It is clear after discussions with other Boards that reports will vary greatly from Board to Board as there was no real guidance with regard to this. Formal feedback will be sent directly to Elaine Mead, Chief Executive probably by end of July, although the date is yet to be confirmed. Discussions are still ongoing at the National HPHS network meetings with regards to some of the measures e.g. one of the smoking ones is not measureable. The CHP has been assured that the template is still a working document and changes may come on the back of the formal feedback. NHS Health Scotland has worked over past year with Health Practitioners across NHS Health Boards to develop resources that showcase Health Promoting Health Service (HPHS) work undertaken by NHS Boards across Scotland. The resources include, five new HPHS Case Studies illustrating tangible health improvement activities in number of different settings and two new professional profiles highlighting the elements of health improvement in staff’s roles within clinical settings. We will consider how best to disseminate these to make the most impact on developing front line practitioners’ practice. All the resources are underpinned by the HPHS concept that 'every healthcare contact is a health improvement opportunity'. Details on some of these Case Studies and Professional Profiles and where they can be found online and the links are detailed below. http://www.healthscotland.com/documents/21434.aspx http://www.healthscotland.com/documents/21437.aspx Councillor Robertson asked if Health Improvement work is undertaken in partnership with social enterprises, with an SLA in place relating to, for example, Health & Wellbeing.

The Committee: Noted the content of the Infection Control Report

Page 11: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

9

Ms Garman advised that small grants funds are available for social enterprises through the Health and Wellbeing Partnership and indicated that should larger grants/projects be required that could be considered in the context of the funding available. Councillor Robertson clarified that her enquiry was not just project specific and related to all Health Improvement projects. 8. Financial Governance 8.1 Finance Report 8. Financial Governance 8.1 Report Mr Morrison advised that at end May 2013 the CHP recorded an overspend of £137,000. He summarised the main anticipated financial challenges for the CHP to operate within the budget as :

� Containment of the NHS Greater Glasgow & Clyde Service Level Agreement � Delivery of the £2.4m saving plan � Containment of ongoing locum costs � Increased commissioned service costs � The establishment of the salaried dental service as a cash limited service.

Mr Creelman requested further details of the ongoing locum costs. Mr Morrison advised that with regard to Cowal, plans are being developed to address the necessity for medical locum cover in casualty, out of hours and inpatient services. Within Oban there is currently a time lag in the filling of medical locum positions. Investigation is also underway to look at the unexpected variance in the provision of surgical locums, which relates to annual leave cover. With regard to salaried dental services, Mr Morrison advised that NHS Boards have been requested to review their funding request for salaried dental services and the detail of the Scottish Government allocation is awaited. An update will be provided at the next meeting. Mr Morrison referred to the financial challenges to the CHP to deliver the cost improvement programme 2013/14, which reflects a target of a 2% saving, with the exception of the prescribing budget which is higher due to significant savings on generic drugs and displaced staff which is a specific target relating to a small number of unfunded posts. Mr Leslie advised that budget holders have been requested to bring forward specific initiatives of their savings plans for discussion at the next CHP Core Management Team meeting. The Committee Noted the content of the report and the financial challenge facing the Argyll & Bute CHP in 2013/14.

The Committee: Noted the content of the Health Improvement Report.

Page 12: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

10

9. Staff Governance 9.1 PDP/R and eKSF Implementation Mr Logue reported the final CHP figures at end of year 2012/13 for agenda for change staff having an eKSF review carried out and recorded on line as 65.42% of staff (all) and 88.61% of staff (excluding Bank). Monitoring progress is underway for 2013/14 and the CHP currently has 2% of all staff (2.68% excluding Bank staff) with reviews and personal development plans signed off in eKSF. Mr Logue emphasised that there needs to be a focus on :

• addressing issues of missing data for a number of staff. • ongoing work in each area to ensure that all bank staff have an identified

manager, outline and review . • planning the dates for PDPs well in advance to spread reviews throughout the

year • ensuring and improving quality of reviews and evidence through guidance notes

and advisory sessions for managers with the Workforce Development Facilitator.

The benefits of the eKSF process being part of the day to day working process to support and inform staff is recognised by Managers. Mr Logue acknowledged the need for re-engagement with CHP focus group to provide support and assurance around the eKSF process and this will be taken forward. Ms Tyrrell suggested the development of feedback questions for team leaders to take forward with staff. It was agreed that, when available, the results of the current staff survey will be submitted to the Committee for discussion. 9.2 Minute of Partnership Forum Meeting of 4 April 2013 Mr Logue highlighted the presentation given to the Partnership Forum by Ms Tyrrell on NHS Mid Staffordshire Report and the circulated Minute reflects the subsequent discussion. The Partnership also discussed the option appraisal around radiography services and it was acknowledged that this is a challenging piece of work.

The Committee: • Noted the end of 2012/13 position • Noted the start of year position • Noted the progress made in embedding this in practi ce and the use to

support and inform staff development in line with C HP and NHS Highland objectives

• Note the plans to ensure reviews and PDPs are start ed early in the year and spread throughout the year

• Note the need to ensure that all bank staff have a review

The Committee: Noted the verbal update and the content of the circ ulated Minute.

Page 13: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

11

10. Partnership Working 10.1 Public Partnership Forum (PPF) As the notes of the meeting on 21 May 2013 were unavailable, Mr Creelman requested a verbal update. Mr Martin reported that after discussion, and taking into consideration comments from members, it has been agreed to change the core function of the Argyll & Bute PPF with the locality PPF Leads meeting quarterly where issues from each locality PPF would be discussed. Locality PPF groups will continue to meet regularly. 10.2 Minute of CPP Management Committee Meeting of 6 March 2013 Mr Leslie referred to the circulate Minute which was to inform the Committee of the business of the Community Planning Partnership. He advised that the draft Single Outcome Agreement will be submitted in due course to the Committee for discussion and agreement.

The Committee: Noted the content of the circulated Minute. 11. Performance Management 11.1 Delayed Discharge Report The circulated monthly census recorded zero delayed discharges >4 weeks within the CHP as at 15 May 2013. The Committee Noted the details of the circulated report.

12. Mental Health Modernisation Update Mr Leslie highlighted details of the circulated report which gave an update on the implementation of the modernisation of mental health services in Argyll & Bute. Capital Project Stage 1 Approvals - the revised stage 1 report was submitted by Hubco to NHS Highland during May, and has been passed to our advisors for review and comment. The Outline Business Case (OBC) is being updated with information from the stage 1 report. At present no dates have been set for presenting the OBC as discussion are ongoing with regard to “bundling” this project with another NHS Highland or NHS Grampian Project. More detail on this is available later in this report.

Inpatient Services - the bed compliment remains at 28 plus 3 minimal supervision places in the refurbished Firgrove building.

The Committee: Noted the verbal update.

Page 14: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

12

Budget - The bridging allocation for the project during 2013/14 remains unchanged at £500k as set by the CHP management team. This will largely be used to cover the capital project, project management and advisor costs, which are expected to exceed £400k this year and drop off during 2014/15. A review of the expected capital project costs for 2013/14 will take place after decisions are made regarding “bundling” options. Community Mental Health Team Base - both Kintyre and Dunoon CMHS bases are almost complete. The Kintyre team will move into their new base in Campbeltown Hospital, along their Social work colleagues and the Kintyre ABAT team, later this month. The Cowal Integrated CMHS will also be relocating from Dochas Lodge to their new base in Cowal Community Hospital later in June.

Supported Transfer of Detained Patients - a staff/management working group has been established to take forward the implementation of this service development. Proposals for an increase in hospital nursing staff was taken to the vacancy monitoring group and approved in principle, but requiring approval by the core team due to the cost implications, as this development requires an additional £100k recurring funding to implement. Staff meetings have also been organised to explain the changes to staff, in particular the alteration to their shift patterns to enable the service to operate at times when it will be most effective for patients.

“A Vision for Mental Health Service in Argyll & Bute” – Workshop held on 29th April - the “Vision” working group met recently to review the outputs from the workshop and to use them to update the vision statement. The revised vision statement will be circulated internally and to partners during June/July for comment.

Mr Leslie summarised that while progress continues to be made in establishing new community services and upgrading current hospital services; the capital project is entering a critical phase. Key decisions will soon be made with regard to bundling with another capital project which will enable the project to continue to progress. Decisions taken over the next few weeks will be vital in terms of defining the length of time to complete, and the overall cost of the new mental health unit. The Committee: Noted the current key issues and progress against the action plan. 13. AOCB There was no other business. 14. DATE, TIME & VENUE FOR NEXT MEETING: Wednesday 21 August 2013, Meeting Room, Fire Statio n, Oban

Page 15: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

Argyll & Bute CHP Committee Date of Meeting : 21 August 2013 Agenda : 7.1 Argyll and Bute CHP Clinical Governance and Risk Ma nagement Report Report by Pat Tyrrell, Lead Nurse and Fiona Campbel l, Clinical Governance Manager

The CHP Committee is asked to:

• Note the contents of the Clinical Governance and Risk Management Report.

1. CONTRIBUTION TO THE BOARD’S CORPORATE OBJECTIVES The vision of the Highland Quality Approach is:

• Better Health – improving the health of the population • Better Care – enhancing the experience of care for individuals • Better Value – controlling the per capita cost of care

In order to achieve this the key elements of the Quality Strategy have been adopted: Person-Centred There will be mutually beneficial partnerships between patients, their families and those delivering healthcare services which respect individual needs and values and which demonstrate compassion, continuity, clear communication and shared decision-making. Safe There will be no avoidable injury or harm to people from healthcare they receive, and an appropriate, clean and safe environment will be provided for the delivery of healthcare services at all times. Effective The most appropriate treatments, interventions, support and services will be provided at the right time to everyone who will benefit, and wasteful or harmful variation will be eradicated.

Page 16: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

2. RISK MANAGEMENT 2.1 Incidents The following data relates to incidents reported between 1 April to 30 June 2013. The data is correct as of 22 July 2013. FIGURE 1 Argyll and Bute Incidents Last 13 months

FIGURE 2 Incidents by Category

A total of 515 incidents were reported within Argyll & Bute during quarter 1. By locality Cowal & Bute – 81 (15.7%) Helensburgh – 11 (2.1%) Mid Argyll & Kintyre – 257 (49.9%) Oban, Lorn & Isles – 158 (30.7%) Outwith – 8 (1.5%)

In the last financial quarter slips trips and falls remained in the highest category of incidents. The top category for each locality: Cowal & Bute – transfer / discharge (14) Helensburgh – V&A (3) Mid Argyll & Kintyre – V&A (53) Oban, Lorn & Isles – falls (56) Increase in number of incidents related to transfer and discharge is being investigated

Page 17: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

FIGURE 3 Incident Grades by Locality

FIGURE 4 Incident with Major and Extreme Consequenc e

During Quarter 1 the incidents reported in Argyll & Bute were graded as follows: Low – 305 (59.2%) Medium – 139 (27.0%) High – 3 (0.6%) The remaining incidents have not yet been graded.

There were 2 incidents, reviewed by a manager and graded with a consequence of major or extreme. Mid Argyll, Kintyre and Islay- Suicide Oban, Lorn & Isles – SAB

Page 18: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

FIGURE 5 Incidents by Locality and Outcome

FIGURE 6 RIDDOR Reportable Incidents

Overall outcome for Argyll & Bute: No injury / harm – 307 (59.6%) Near Miss – 57 (11.1%) Injury / harm – 137 (26.6%) Death – 1 ( 0.2%) Property damage – 13 (2.52%)

There were 2 RIDDOR incidents in Quarter 1 . 1 x > 7 day absence – staff accident. Injury to thumb 1 x major injury – staff fall. Fractured patella

Page 19: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

:

5

2.1.1 Pressure Ulcer Prevention The graphs below illustrate the trends in Hospital Acquired Pressure Ulcers across NHS Highland. While the overall number remains fairly constant the reduction in Grades 3 and 4 ulcers is sustained. CQI scores for Pressure Ulcer Prevention for each ward in Argyll and Bute are shown in Appendix One. There has been recent increase in capacity of Tissue Viability specialist nursing support within NHS Highland; this will deliver additional support to the clinical staff in ensuring that adherence to standards for pressure ulcer prevention is maintained across all areas. In addition, short life group has been established to develop an action plan to raise awareness, and develop prevention strategies, across community and primary care settings. This will include working with carers and staff in Care Homes and Care at Home services. FIGURE 7: NHS HIGHLAND HOSPITAL ACQUIRED PRESSURE U LCERS JULY 2012-JULY 2013

FIGURE 8: OPERATIONAL UNITS: HOSPITAL ACQUIRED PRES SURE ULCERS JULY 2012-JULY 2013

Page 20: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

:

6

FIGURE 8: HOSPITAL ACQUIRED PRESURE ULCERS BY HOSPI TAL APRIL – JUNE 2013

FIGURE 10: PRESSURE ULCERS DEVELOPED IN COMMUNITY J ULY 2012-JULY 2013

Page 21: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

:

7

2.1.2 Falls Prevention As with Pressure Ulcer prevention considerable amount of work is underway to reduce the incidence of falls in both hospital and community settings. Application of evidence based interventions, in the assessment and management of risk in those likely to sustain falls, is being tested in Lorn and Islands Hospital in Oban. The graphs below illustrate trends across NHS Highland. CQI scores for Falls Prevention for each ward in Argyll and Bute are illustrated in Appendix One. FIGURE 11: NHS HIGHLAND NUMBER OF FALLS JULY 2012-J ULY2013

FIGURE 12: NUMBER OF FALLS AND CONSEQUENCE BY OPERA TIONAL UNIT APRIL-JUNE

2013

Page 22: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

:

8

2.1.3 Disruptive, Violent and Aggressive Behaviour While incidents related to disruptive, violent and aggressive behaviour are the second highest category reported the numbers for Argyll and Bute are consistently lower than those of the other operational units as shown in the graph below. Training and support for staff is delivered throughout the year to ensure that staff have the right communication and management skills to deal effectively with potential incidents. FIGURE 13: NUMBER OF V&A INCIDENTS BY OPERATIONAL U NIT JULY 2012-JULY 2013

2.1.4 Staff Availability The following graph illustrates the number of incidents reported where there have been problems due to lack of staff availability- the majority of these are due to shortage of nurses in clinical areas. These incidents are kept under close scrutiny. At its July meeting the CHP Core management Team agreed the process for carrying out Argyll and Bute wide review of Nursing and Midwifery establishments during September 2013. This is in line with NHS Highland policy. The process will include representatives from CHP management, finance, HR and staffside as well as the Senior Charge Nurses and Team Leaders. It is anticipated that the revised establishments will be agreed and signed off in December/January FIGURE 14: NUMBER OF INCIDENTS RELATED TO STAFF SHO RTAGES BY OPERATIONAL UNIT JULY 2012-JULY 2013

Page 23: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

:

9

2.2 Significant Event Reviews (SER) There have been four SERs since the last report. Each of these has been investigated with the staff who were involved and reports and action plans generated. SERs are an essential element of risk management and form an integral part of the improvement in the safety and quality culture. Feedback from staff about their experience of the SER process continues to inform developments and improvements in the way in which the need for SERs is identified, the way in which the reviews are conducted and in how the action plans are developed and monitored. 2.3 Health Improvement Scotland Adverse Event Revie w Health Improvement Scotland (HIS) Adverse Event Management visit to review NHS Highland in relation to the management of adverse events took place on 07 August 2013. HIS are undertaking review visits to all Boards within NHS Scotland. There were a number of sessions included in the programme which allowed the visiting team to talk to various members of staff about adverse event arrangements within NHS Highland including:

• Discussion with Senior Managers • Demonstration of systems in place e.g. Datix, record storage, staff training • A visit to a clinical area in Raigmore to talk with front-line staff to understand their

perspective about the management of adverse incidents. • Discussion with staff involved in 4 selected incidents. One of these sessions was

with A&B CHP staff in relation to a incident which occurred in Argyll and Bute and which was subject to a Significant Event Review

A draft report will be provided by HIS with final report due to be published on 23 September 2013. 3. COMPLAINTS TABLE 1 Argyll and Bute Complaint Performance repo rt

Target Amber Red April- 13

May- 13

June- 13

Number of complaints received 4 5 ~ 6 7 and over 9 6 7 Achievement against 20 day 80% 70 - 79% Under 69% 33% 0% 0% Number of complaints over 40 working days old * 0 ~ 1 or more 1 2 5 Number of further correspondence over 20 working days old * 0 ~ 1 or more 2 1 1 Number of complaints categorised as high risk 1 2 3 and over 2 4 2

Page 24: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

:

10

Of the 7 complaints received in June 2013 the themes contained within complaints can be broadly categorised as follows:

Waiting Times 3 Access to Services 2 Care / Treatment 2

4. EXTERNAL REVIEWS 4.1 Joint Inspection of Children’s Services in Argy ll and Bute The pilot inspection in Argyll and Bute was completed in April 2013. The draft report has been received and the final report is due to be published in September. Work is already underway to address the identified areas for improvement. 5 QUALITY AND SAFETY 5.1 Scottish Patient Safety Programme Acute Services: Detailed run charts for Lorn and Islands Hospital are included in Appendix Two INR: slightly raised due to one patient with a raised INR on admission. Spread across wards all sustaining improvement. Sepsis: data input from two wards now. VTE –to be taken forward when NHS Highland agree the appropriate tool. Mortality review – June – December 2012 looked at and report sent to Dr Bashford. All deaths reviewed and no adverse events identified. January – June 2013 to be audited. Primary Care A local learning event for GPs, Practice Nurses and Practice Managers was held in Inveraray on 6 June 2013 with 24 of the 33 Argyll and Bute GP practices represented at the meeting (44 attendees) The training session was facilitated by Dr Kirsty Vickerstaff, SPSP-PC GP Clinical Lead for NHS Highland, Dr Neil Houston, National Clinical Lead for Healthcare Improvement Scotland and Jill Gillies, SPSP-PC Programme Manager. The event provided information regarding the tools and resources of the primary care safety programme to improve patient safety and specifically supported practices with the two elements which have been included in the Quality and Outcomes framework this year;

• The Safety Climate Survey • Structured Case Note Review using the Primary Care Trigger Tool

Page 25: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

:

11

The NHS Highland SPSP-PC working group identified Warfarin Management as a key area of focus for NHS Highland. Argyll and Bute CHP is currently developing an enhanced service for anti-coagulation monitoring incorporating the SPSP-PC Warfarin Care Bundle for introduction across Argyll and Bute CHP from 1 April 2014. A care bundle is a structured way of improving processes of care to deliver enhanced patient safety and clinical outcomes. Dr John Lyon, Argyll and Bute SPSP-PC Clinical Lead and Joyce Robinson, Primary Care Manager are representing Argyll and Bute CHP at an NHS Highland site visit by Healthcare Improvement Scotland on 27 August in Inverness to agree an action plan for future activities, including further learning sessions (National and Local), IT and Data collection and enhanced service progress. 6. HEALTH AND SAFETY 6.1 Revised Health and Safety Work Programme The NHS Highland work programme for Health and Safety 2013 – 2015 is being revised and updated. The programme will be split into corporate and operational work strands and each area of work will have targets and performance measures. The work programme is to be included as part of the Operational Units Delivery Plan and its implementation will be overseen by the Joint Chairs of the Operational Health and Safety Groups and monitored by the Health and Safety Committee. To avoid unnecessary duplication of effort each corporate work stream will have a NHSH Lead. The corporate work programme will be tabled for approval at the August NHSH H&S Committee. The CHP operational plan will contain all the work streams within the corporate plan plus areas of work to meet local concerns, identified e.g. through incident reporting or risk assessment. The A&B CHP Operational Plan will be tabled at the CHP Operational Health and Safety Group on 22 August 2013. Future reports to the CHP Committee will include performance related information in relation to achievement of the work plan 6.2 Moving and Handling Audits The Moving and Handling Advisor along with the area co-ordinator/trainers in moving and handling have begun baseline audits for moving and handling. These baseline audits will be conducted within wards in each hospital. Items covered by the audit include: the level and frequency of training received by staff, the competence of individuals and the availability and quality of moving and handling risk assessments. These audits will help to determine any gaps in competence and written assessments. This will provide essential information as we make the transition from a prescribed frequency of moving and handling training to one based on the competence of individuals.

Page 26: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

:

12

7. FIRE SAFETY 7.1 Fire Risk Assessments Fire risk assessments carried out by the CHP Risk Advisor, Fire Safety, using the 3i system continue to progress. Garelochhead; Kilcreggan; Campbeltown, Islay, Lorn & Islands, Dunoon, Rothesay and Mid Argyll are now complete and have been issued. Action plans are being prioritised locally. The target for completion of the risk assessment for Mull and Iona Community Hospital is the end of August. 7.2 Compartmentation Survey Recent fire service audits have highlighted the need for compartmentation work to be undertaken. Sub-compartmentation of wards is a key priority. The fire alarm systems have been upgraded to L1 standard in Dunoon and Oban. 7.3 Unwanted Fire Alarm Signals TABLE 2: ARGYLL AND BUTE INCIDENTS CODED TO FIRE CA TGEORY APRIL 2013- JUNE 2013 A&B CHP Incidents coded to Category Fire 1st Q 1.4.13-30.6.13

Failure

with alarm system

Fire (actual)

Unwanted fire alarm signal (false alarm)

Total

Hospital - Argyll & Bute 0 0 1 1 Hospital - Bute - Rothesay Victoria Hospital 0 0 3 3 Hospital - Campbeltown 0 1 2 3 Hospital - Dunoon - Cowal Community Hospital 0 0 2 2 Hospital - Lochgilphead - Mid Argyll Community Hospital, Integrated Care 0 0 2 2 Hospital - Oban - Lorn and Islands General Hospital 1 1 2 4 Workbase / Office / Training - Aros 0 0 1 1 Total 1 2 13 16

The two Fires (actual) in Campbeltown and Lorn and Islands Hospital were as a result of overheating of equipment. Some unwanted signals were attributed to new alarm systems. Staff have been informed of the higher level of detection due to the new alarm systems and have been reminded to prevent unwanted calls by inappropriate actions e.g. using nebulisers, kettles or toaster in non designated areas or rooms. Six calls were due to works carried out by contractors. Procedures for the management of contractors need to reviewed by Estates to ensure they are fully implemented.

Page 27: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

:

13

7.4 Fire Service Audits The enforcing authority, Scottish Fire and Rescue Service (SFR), has now completed audits in Cowal, Rothesay, Islay, Campbeltown and Oban hospitals. Duty holders have received letters of recommendations; no formal action has been issued. Duty holders have responded by letter to the fire authority. Although SFR detail the full scope of works required, the letters indicate an immediate need for some interim works. These centre on the sub division of ward areas. All sites have Fire Safety Action Plans in place both as a result of the 3i risk assessments and the Fire Service Audits. Immediate actions are being progressed at all sites. Further funding is being sought to deal with some of the estates issues required.

Page 28: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...
Page 29: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

:

14

APPENDIX ONE: CLINICAL QUALITY INDICATOR COMPLIANCE SCORES CQI Rates: % compliance with standards for Pressure Ulcer Prevention SEPTEMBER OCTOBER NOVEMBER DECEMBER JANUARY FEBRUARY MARCH APRIL MAY JUNE JULY COWAL AND BUTE Victoria Hospital

100 95 100 100 93 93 98 95 98 93 96

CCH Ward 1 98 96 96 98 96 100 100

98 CCH Ward 2

98 100 96

MID ARGYLL, KINTYRE AND ISLAY Glenaray 95 100 95 93 95 95 100 100 83 100 100

Glassary 100 100 100 100 100 100 Cara Knapdale

100 100 100

Campbeltown NR 97 95 100 100 100 100 98 98

100 100 Islay 90 90 90 90 92 95 100 100 100 100 100

OBAN, LORN AND ISLES Ward A 95 100 100 100 100 100 83 100 100 100 100

Ward B 100 100 98 100 93 95 100 100 95 98 Ward I 100 100 100 100 100 100 100 100 100 100 100

MICH 95 NR NR 78 100 NR 91 92 100 100

Page 30: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

:

15

APPENDIX ONE: CLINICAL QUALITY INDICATOR COMPLIANCE SCORES CQI rates: % compliance with Standards for Falls Pr evention SEPTEMBER OCTOBER NOVEMBER DECEMBER JANUARY FEBRUARY MARCH APRIL MAY JUNE JULY COWAL AND BUTE Victoria Hospital

100 100 100 91 96 100 100 100 100 91 100

CCH Ward 1 96 97 97 97 97 100 96 95

CCH Ward 2

100 96 98

MID ARGYLL, KINTYRE AND ISLAY Glenaray 100 100 100 100 100 100 100 100 100 100 100

Glassary 100 100 100 100 100 100 100 100

Cara Knapdale

100 100 100

Campbeltown NR 100 94 100 96 76 89 100 96.3 100 98

Islay NR 87 90 90 93 67 96 84 82 100 96 OBAN, LORN AND ISLES Ward A 96 96 97 100 97 96 100 100 100 100 100

Ward B NR 100 98 98 87 100 100 100 97 98 Ward I 100 100 100 100 100 100 100 100 100 100 100

MICH 100 NR NR 61 94 NR 100 100 100 100

Page 31: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

:

16

APPENDIX ONE: CLINICAL QUALITY INDICATOR COMPLIANCE SCORES CQI Rates: %compliance with Standards for Food, Flu ids and Nutritional Care SEPTEMBER OCTOBER NOVEMBER DECEMBER JANUARY FEBRUARY MARCH APRIL MAY JUNE JULY COWAL AND BUTE Victoria Hospital

99 97 93 NR NR 98 96 97 NR 97 98

CCH Ward 1 92 96 95 95 97 100 98 100

CCH Ward 2

97 99 100

MID ARGYLL, KINTYRE AND ISLAY Glenaray 67 89 100 100 99 100 94 100 91 100 97

Glassary 100 100 100 100 100 100 100 100

Cara Knapdale

100 100 100

Campbeltown 96 94

Islay 100 OBAN, LORN AND ISLES Ward A 100 100 100 100 100 100 100 100 100 100 100

Ward B 100 100 99 94 95 100 100 100 97 97 Ward I 100 93 100 100 100 100 100 100 100 100 100

Page 32: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...
Page 33: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

- 17 -

APPENDIX TWO LORN AND ISLANDS SPSP PROCESS AND OUTCOME MEASURES

Page 34: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

- 18 -

APPENDIX TWO LORN AND ISLANDS SPSP PROCESS AND OUTCOME MEASURES

Page 35: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

- 19 -

APPENDIX TWO LORN AND ISLANDS SPSP PROCESS AND OUTCOME MEASURES

Page 36: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

- 20 -

APPENDIX TWO LORN AND ISLANDS SPSP PROCESS AND OUTCOME MEASURES

Page 37: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

- 21 -

APPENDIX TWO LORN AND ISLANDS SPSP PROCESS AND OUTCOME MEASURES

Page 38: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...
Page 39: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

Argyll & Bute CHP Committee Date of Meeting: 21 August 2013

Item No: 7.2

INFECTION CONTROL REPORT Report by Pat Tyrrell, Lead Nurse The CHP Committee is asked to: • Note the contents of the report.

1. Aim The purpose of this paper is to update CHP Committee members of the current status of Healthcare Associated Infections (HAI) and infection control measures in Argyll and Bute CHP and NHS Highland.

2. Contribution to Board Objectives One of the Board key objectives is “to reduce to an absolute minimum the chance of acquiring an infection whilst receiving healthcare and to ensure our hospitals are clean”. 3. Summary TABLE 1 NHS HIGHLAND INFECTION PREVENTION & CONTROL TARGETS AND PERFORMANCE DATA Group Target NHS

Scotland NHS Highland

Clostridium difficile

Age 65 and over

39.0 (100,000 OBDs)

28.4 April 12 - March 2013

20.8 April 12 – March 2013.

Green

Clostridium difficile

Age 15 and over

New Target 25.0 (100,000 OBDs) to be achieved by 03/15

26.4 April – June 2013 (not validated) Please note* below

Green

Staphylococcus aureus bacteraemia

Age 15 and over

26.0 (100,000) AOBDs

29.8 April12 –March 2013.

21.8 April 12 – March 2013.

Green

Hand Hygiene 95% 95% 98% Green

Cleaning 90% 95%

95% Green

Estates

90% 97% 96% Green

Source: - Health Protection Scotland/ISD/Local data. * Please note that NHS Highland Local Delivery Plan Target Trajectory for Clostridium difficile cases in patients aged 15 and over at June 2013 is 34 per 100,000 OBDs.

Page 40: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

:

2

4. Achievements NHS Highland has met the HEAT targets for Staphylococcus aureus bacteraemia (SAB) and Clostridium difficile in patients aged 65 and over as at March 2013.

5. Challenges

• To influence the prevention and reduction of Clostridium difficile infections acquired in the community in the 15 – 64 age group.

• To reduce MSSA bacteraemias by engaging all clinical staff in hospitals and the community in initiatives to prevent and reduce device/healthcare related infections.

• To address the need for risk assessment and screening for Multi-Drug Resistant bacteria (Carbapenemase producers) in light of recent Interim Guidance from Health Protection Scotland.

Argyll and Bute CHP Healthcare Associated Infection Report –

Page 41: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

:

3

August 2013

Section 1 – NHS Highland Board Wide and Argyll and Bute Issues

1. Staphylococcus aureus (including MRSA)

1.1 Staphylococcus aureus bacteraemia target NHS Highland has met the HEAT target of 26.0 cases per 100,000 acute occupied bed days or lower by year ending March 2013. The annual rate, April 2012 – March 2013, is 21.8 per 100,000 acute bed days (55 cases). From April 2013, NHS Boards are required to further reduce healthcare associated infections so that by year ending March 2015, S taphylococcus aureus bacteraemia (including MRSA) cases are 24.0 cases or less per 1 00,000 acute bed days. For NHS Highland that means no more than 60 cases.

1.2 Trends National data published by Health Protection Scotland identifies that NHS Scotland Staphylococcus aureus bacteraemia rate January – March 2013 was 30.1 per 100,000 acute occupied bed days. NHS Highland rate for the same period was 21.7 per 100,000 acute occupied bed days (14 cases).

Staphylococcus aureus is an organism which is responsible for a large number of healthcare associated infections, although it can also cause infections in people who have not had any recent contact with the healthcare system. The most common form of this is Meticillin Sensitive Staphylococcus Aureus (MSSA), but the more well known is MRSA (Meticillin Resistant Staphylococcus Aureus), which is a specific type of the organism which is resistant to certain antibiotics and is therefore more difficult to treat. More information on these organisms can be found at:

Staphylococcus aureus :

http://www.nhs24.com/content/default.asp?page=s5_4&articleID=346

MRSA: http://www.nhs24.com/content/default.asp?page=s5_4&articleID=252

NHS Boards carry out surveillance of Staphylococcus aureus blood stream infections, known as bacteraemias. These are a serious form of infection and there is a national target to reduce them. The number of patients with MSSA and MRSA bacteraemias for the Board can be found at the end of Section 1 and for each hospital in Section 2. Information on the national surveillance programme for Staphylococcus aureus bacteraemias can be found at:

http://www.hps.scot.nhs.uk/haiic/sshaip/publicationsdetail.aspx?id=30248

Page 42: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

:

4

FIGURE 1 STAPHYLOCOCCUS AUREUS BACTERAEMIA (MRSA AN D MSSA) CASES PER 100,000 OCCUPIED BED DAYS ALL AGES JANUARY 2010 – J UNE 2013

With 95% confidence interval (vertical lines), linear trend (black line) and target (red line) = 26, ci = confidence interval TABLE 2 SHOWS THE CUMULATIVE TOTALS FOR SAB WITHIN ARGYLL AND BUTE CHP FOR THE YEARS SINCE 2009-2010: Hospitals 09/10 10/11 11/12 12/13 13/14 Lorn and Islands, Oban 8 3 0 5 2 Victoria Hospital, Rothesay 1 1 0 0 0 Mid Argyll Hospital, Lochgilphead 0 1 0 0 0 Argyll & Bute Hospital, Lochgilphead 0 0 0 0 0 Campbeltown Hospital 0 0 0 0 0 Dunaros, Mull 0 0 0 0 0 Islay Hospital, Bowmore 0 0 0 0 0 Cowal Community Hospital, Dunoon 0 0 0 0 0 Both cases of SAB that occurred in Lorn and Islands Hospital, Oban have been scrutinised using the Root Cause Assessment tool. The first case appears to have been related to contaminated blood cultures and therefore not a true SAB. To ensure that correct aseptic technique is used when taking blood cultures, work is underway with medical staff at Lorn and Islands Hospital. The second case occurred in a patient with an invasive device (PICC Line) undergoing chemotherapy as a day case. As a result of the case analysis we are reviewing the need to undertake routine MRSA screening for all day case patients ( not currently included in the guidance).

Page 43: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

:

5

2. Clostridium difficile

2.1 Clostridium Difficile Target NHS Highland has met the HEAT target of 39 cases per 100,000 total occupied bed days or lower in patients aged 65 and over by year ending March 2013. The annual rate, April 2012 – March 2013 is 20.8 cases per 100,000 OBDs (40 cases). National data published by Health Protection Scotland identifies that NHS Scotland Clostridium difficile infection rate in patients aged 65 years and over, January – March 2013 was 24.2 cases per 100,000 bed days. NHS Highland rate for the same period was 10.3 cases per 100,000 bed days (5 cases). National data identifies that NHS Scotland Clostridium difficile infection rate in patients aged 15 – 64 years, January – March 2013 was 28.4 cases per 100,000 bed days. NHS Highland rate for the same period was 43.9 cases per 100,000 bed days (7 cases). From April 2013, NHS Boards are required to further reduce healthcare associated infections so that by year ending March 2015, the r ate of Clostridium difficile infections in patients aged 15 years and over is 25 .0 cases or less per 100,000 total occupied bed days. For NHS Highland that means no more than 70 cases. 2.2 Trends FIGURE 2 CLOSTRIDIUM DIFFICILE CASES PER 100,000 OCCUPIED BED DAYS, 65 YEARS AND OVER JANUARY 2010 – MARCH 2013

Clostridium difficile is an organism which is responsible for a large number of healthcare associated infections, although it can also cause infections in people who have not had any recent contact with the healthcare system. More information can be found at:

http://www.nhs.uk/conditions/Clostridium-difficile/Pages/Introduction.aspx

NHS Boards carry out surveillance of Clostridium difficile infections (CDI), and there is a national target to reduce these. The number of patients with CDI for the Board can be found at the end of Section 1 and for each hospital within the CHP in Section 2. Information on the national surveillance programme for Clostridium difficile infections can be found at:

http://www.hps.scot.nhs.uk/haiic/sshaip/ssdetail.aspx?id=277

Page 44: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

:

6

April – June 2013 rate (not yet validated by HPS) of Clostridium difficile infections in patients aged 15 and over is 26.4 cases per 100,000 total occupied bed days, 17 cases of which 6 were in hospital and 11 were out of hospital. FIGURE 3 SHOWS THE RATE OF CLOSTRIDIUM DIFFICILE INFECTIONS IN PATIENTS AGED 15 AND OVER FROM APRIL 2012 to June 2013 IN NHS HIGHLA ND

TABLE 3 SHOWS THE CUMULATIVE CD TOXIN POSITIVE CASE S IN EACH CHP HOSPITAL FOR THE YEARS SINCE 2009

Hospitals 09/10 10/11 11/12 12/13 13/14

Lorn and Islands Hospital, Oban 0 1 2 1 1

Cowal Community Hospital, Dunoon 3 1 2 2 1

Victoria Hospital, Rothesay 3 0 1 0 1

Dunaros, Mull 0 1 0 0 0

Argyll & Bute Hospital, Lochgilphead 0 0 0 0 1

Mid Argyll Hospital, Lochgilphead 0 0 1 0 0

Campbeltown Hospital 0 0 1 1 2

Islay Hospital, Bowmore 0 0 0 0 0

TABLE 4 SHOWS THE CUMULATIVE CD TOXIN POSITIVE CASE S IN COMMUNITY FOR THE YEARS SINCE 2009

Page 45: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

:

7

09/10 10/11 11/12 12/13

13/14

North and West Unit 22 3

South and Mid Reported as CHPs 21 2

Argyll & Bute CHP 2 4 2 2 2

There has been an increase in cases of CDI in Argyll and Bute since April 2013, with a total of 8 cases recorded- 6 in hospital and 2 in community. Of the 6 hospital cases, two of these were a recurrence of infection within the same two patients. There has been no epidemiological connection between the cases, no spread of infection within the wards in which the patients were being cared for and all patients have recovered. Point prevalence study of antimicrobial prescribing practice will take place across each hospital in September to identify how well we are complying with the guidance. In addition education sessions are being delivered in sites across the CHP for all prescribers to maintain the focus on appropriate prescribing of anti microbial agents. 3. Hand Hygiene

3.1 Trends NHS Highland Hand Hygiene Rolling Monthly Audit Programme continues across all clinical areas sustaining 98% compliance in May and June 2013 The July 2013 National Hand Hygiene Audit report shows NHS Highland compliance as 98%, National compliance was 96%. 3.2 Initiatives Hand hygiene audits continue to be undertaken monthly by all clinical areas, the results displayed and any non compliance addressed. All areas in Argyll and Bute continue to demonstrate compliance with the standards- the results for each hospital are included within the charts in section 2 of the report. 4. Cleaning and the Healthcare Environment

Good hand hygiene by staff, patients and visitors is a key way to prevent the spread of infections. More information on the importance of good hand hygiene can be found at:

http://www.washyourhandsofthem.com/

NHS Boards monitor hand hygiene and ensure a zero tolerance approach to non compliance. The hand hygiene compliance score for the Board can be found at the end of section 1 and for each hospital and community hospitals within each CHP in section 2. Information on national hand hygiene monitoring can be found at:

http://www.hps.scot.nhs.uk/haiic/ic/nationalhandhygienecampaign.aspx

Page 46: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

:

8

4.1 Current Rates The monthly cleaning and estates audits as per the National Cleaning Services Specification demonstrated 95% compliance in May and 94% in June 2013 for domestic monitoring and 97% for estates monitoring in May and 95% in June 2013. results for Argyll and Bute hospitals are included in the scorecards and show compliance across all sites. 5. Outbreaks/Incidents There have been no outbreaks or incidents in Argyll and Bute since the last report. 6. Education Following the findings of the HSE visit to Lochaber and the subsequent improvement work that was undertaken, NHS Highland has developed minimum standards for Infection Control education for community nurses. These require that all team members undertake the following:

- NHS Highland Hand Hygiene module - HAI Mandatory Induction Training Programme - Principles of Aseptic Technique

All teams in Argyll and Bute are currently progressing with these, with most expected to complete by the end of September 2013. In addition Team Leaders/ Case Load Holders are requested to undertake the Cleanliness Champion Programme by March 2014. 7. Audit National audit tools have been developed in order to measure compliance with the national Infection Prevention and Control Manual Standard Infection Control Precautions. Baseline audits have been carried out in Lorn and Islands Hospital and Campbeltown Hospital. Plans are being progressed to implement a rolling audit plan within each hospital; when these have been implemented results from the audits, which will be reported monthly, will be utilised to identify areas of good practice and areas where improvement is required. 8. Argyll and Bute Workplan 2013-2014 The annual Infection Control Workplan for 2013-2014 is attached to this report as Appendix One.

Healthcare Associated Infection Reporting Template (HAIRT)

Keeping the healthcare environment clean is essential to prevent the spread of infections. NHS Boards monitor the cleanliness of hospitals and there is a national target to maintain compliance with standards above 90%. The cleaning compliance score for the Board can be found at the end of Section 1 and for each hospital and community hospitals within each CHP in Section 2. Information on national cleanliness compliance monitoring can be found at:

http://www.hfs.scot.nhs.uk/online-services/publications/hai/

Healthcare environment standards are also independently inspected by the Healthcare Environment Inspectorate. More details can be found at:

http://www.nhshealthquality.org/nhsqis/6710.140.1366.html

Page 47: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

:

9

Section 2 – Healthcare Associated Infection Report Cards The following section is a series of ‘Report Cards’ which provide information on the number of cases of Staphylococcus aureus blood stream infections (also broken down into MSSA and MRSA) and Clostridium difficile infections. Hand hygiene and cleaning compliance completes the report card. This includes information for pan Highland, Lorn and Islands Hospital, Oban, Community Hospitals collectively for Argyll and Bute and NHS Highland out of hospital infections. The information in the report cards is provisional local data, and may differ from the national surveillance reports carried out by Health Protection Scotland and Health Facilities Scotland. The national reports are official statistics which undergo rigorous validation, which means final national figures may differ from those reported here. However, these reports aim to provide more detailed and up-to-date information on HAI activities at local level than is possible to provide through the national statistics. Understanding the Report Cards – Infection Case Num bers Clostridium difficile infections (CDI) and Staphylococcus aureus bacteraemia (SAB) cases are presented for each hospital, broken down by month and the community hospitals within each CHP. Staphylococcus aureus bacteraemia (SAB) cases are further broken down into Meticillin Sensitive Staphylococcus aureus (MSSA) and Meticillin Resistant Staphylococcus aureus (MRSA). Data is presented as both a graph and a table giving case numbers. More information on these organisms can be found on the NHS24 website: Clostridium difficile : http://www.nhs24.com/content/default.asp?page=s5_4& articleID=2139&sectionID=1 Staphylococcus aureus : http://www.nhs24.com/content/default.asp?page=s5_4&articleID=346 MRSA: http://www.nhs24.com/content/default.asp?page=s5_4&articleID=252&sectionID=1 For each acute hospital and community hospitals in the CHP, the total cases for each month are those which have been reported as positive from a laboratory report on samples taken more than 48 hours after admission. For the purposes of these reports, positive samples taken from patients within 48 hours of admission will be considered to be confirmation that the infection was contracted prior to hospital admission and will be shown in the “out-of-hospital” report card. Understanding the Report Cards – Hand Hygiene Compl iance Good hand hygiene is crucial for infection prevention and control. More information can be found from the Health Protection Scotland’s national hand hygiene campaign website: http://www.washyourhandsofthem.com/ Hospitals carry out regular audits of how well their staff are complying with hand hygiene. The first page of each hospital/CHP report card presents the percentage of hand hygiene compliance for all staff in both graph and table form.

Page 48: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

:

10

Understanding the Report Cards – Cleaning Complianc e Hospitals strive to keep the care environment as clean as possible. This is monitored through cleaning compliance audits. More information on how hospitals carry out these audits can be found on the Health Facilities Scotland website: http://www.hfs.scot.nhs.uk/online-services/publications/hai/ The Report Cards show the hospitals’ cleaning compliance percentage in both graph and table form.

Page 49: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

:

11

Page 50: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

:

12

Page 51: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

:

13

Page 52: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

:

14

Page 53: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

:

15

Page 54: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

:

16

Page 55: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

:

17

Page 56: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

:

18

Page 57: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

:

19

Page 58: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

:

20

Page 59: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

:

21

Abbreviations AMT Antimicrobial Prescribing Team

AMAU Acute Medical Admissions Unit

CHP Community Health Partnership

CDI Clostridium difficile Infection

CNO Chief Nursing Officer

CVC Central Venous Catheter

CSM Clinical Services Manager

ECDC European Centre for Disease Prevention & Control

GDP General Dental Practitioner

HAI Healthcare Associated Infection

HAIRT Healthcare Associated Infection Reporting Template

HEAT Health Improvement, Efficiency, Access, Treatment

HEI Healthcare Environment Inspectorate

Hemi arthroplasty An operation used to treat fractured hip similar to a total hip replacement, but involves only half of the hip.

ICU Intensive Care Unit

JAG Joint Advisory Group

MSSA Meticillin Sensitive Staphylococcus Aureus

MRSA Meticillin Resistant Staphylococcus Aureus

PICC Peripherally Inserted Central Catheter

PPI Proton Pump Inhibitor

PVC Peripheral Venous Catheter

QUAD Quality Assurance Document

RIDDOR Reporting of Injuries, Diseases and Dangerous Occupational Regulations 1995

SAB Staphylococcus aureus Bacteraemia

SCN Senior Charge Nurse

SHPN Scottish Health Planning note

SHTM 64 Scottish Health Technical Memoranda – Sanitary assemblies.

SPC Statistical Process Chart

SAPG Scottish Antimicrobial Prescribing Group

SICPs Standard Infection Control Precautions

SPSP Scottish Patient Safety Programme

VAP Ventilator Associated Pneumonia

Page 60: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

:

22

Staphylococcus Aureus Bacteraemia (SAB) criteria

Contaminated blood culture

• Staphylococcus aureus isolated from blood, and • SAB diagnosis incompatible with clinical picture, i.e. no or minimal

clinical signs and symptoms indicating SAB.

Hospital acquired infection

• Staphylococcus aureus isolated from blood cultures taken 48 hours after admission or within 48 hours of discharge, and,

• The presence of clinical signs and symptoms indicating SAB

Community onset-healthcare associated infection

• Staphylococcus aureus isolated from blood cultures taken <48 hours after admission, and

• The presence of clinical signs and symptoms indicating SAB, and • At least one of the following within the past 12 months:

o Hospitalisation or invasive device management as an outpatient / community patient, or dialysis as an outpatient / community patient.

True community infection

• Staphylococcus aureus isolated from blood, and • No hospitalisation within the past 12 months • No dialysis within the past 12 months • No community or outpatient healthcare for invasive device

management in the past 12 months

Page 61: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

23

APPENDIX ONE: NHS Highland Infection Prevention & Control Annual Work Plan 2013/2014 Argyll and Bute CHP

Objective

Activity Timescale Lead Officer

1.HEAT Targets

1.1 To continue to reduce the number of SAB cases to achieve the HEAT Target of 24 cases per 100,000 acute occupied beds days or lower by March 2015

a) By ensuring compliance with device related bundles – PVC, CVC, PICC, CAUTI b) By ensuring compliance with NHS Highland wound management guidelines & formulary. c) By reviewing the causes of community acquired SABs, to give an understanding of what preventable measures are required. d) By reviewing the causes of healthcare acquired SABs, to give an understanding of what preventable measures are required.

March 2015

Lead Nurse Supported by the Infection Prevention & Control Team

a) By monitoring the adherence to the Clostridium difficile policy – to highlight areas for improvement (compliance with hand hygiene, antimicrobial & proton pump inhibitor prescribing, environmental cleanliness & fabric maintenance, appropriate isolation)

March 2015

Lead Nurse Supported by the Infection Prevention & Control Team

1.2. To reduce the number of Clostridium difficile cases to achieve the HEAT Target of 25 cases per 100,000 occupied bed days in patient’s age 15 years and over by March 2015.

b)By ensuring the delivery of the most up to date testing

c)By the use of high quality local data to inform primary and secondary care

March 2014 Infection Control Doctor/Consultant Microbiologists

Page 62: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

24

2. Infection Prevention & Control is everyone’s business

2.1 Embed the importance of Infection Prevention & Control into everyday practice.

a) By ensuring that the ten elements of Standard Infection Control Precautions are implemented and audited to ensure compliant practice. b) By ensuring that there is Infection Prevention & Control input in all new builds/refurbishments as per HAI Scribe. c) By having risk assessed plans in place regarding non- compliant sinks & poor fabric maintenance. d) By ensuring there are systems in place to minimise the health & safety risks to staff using cleaning products e) By auditing compliance with NHS Scotland MRSA Screening policy. f) By ensuring that staff who are exposed to biological agents i.e. aerosol generating procedures, have access to and comply with wearing appropriate PPE.

March 2014 Lead Nurse Supported by the Infection Prevention & Control Team

3.HAI Standards 3.1 Embed the process and governance arrangements for HAI Standards Monitoring.

a) By ensuring there is a programme of HAI standards monitoring visits in each Operational Unit. b) By ensuring that there is a system in place to escalate any actions which cannot be progressed through the line management structure and if necessary to the Chief Operating Officer. c) By submitting quarterly reports to the Infection Control Improvement Group.

March 2014 Lead Nurse Supported by the Infection Prevention & Control Team

4.HAI Education 4.1 Ensure Patient/Service Users safety is achieved in relation to Infection Prevention & Control by standardising HAI education and

a) Implement NHS Highland guidance on Infection Control training for all staff

March 2014 NHS Highland HAI Education Group

Page 63: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

25

training, targeted at different staff groups across NHS Highland in

• Hospitals • Community • Primary Care • Care Homes • Care at Home • Adult Day Care Centres • Learning Disability • Bank Staff • Social Work Staff • Volunteers and Contractors

b) ensure that staff have HAI objective within their PDPs c) ensure that Community Nurses complete the required modules and records of training are available

d) Identify what protected learning time is required for HAI training

e) Look at barriers preventing HAI training

f)Ensure that NHS Highland has a robust system of recording what training has been undertaken

5.Decontamination

5.1 Achieve compliance with all aspects of decontamination.

a) By ensuring that there are systems, processes and facilities for safe endoscopy decontamination. a) By putting systems in place around procurement of equipment to ensure effective decontamination. b) By ensuring that there are systems, processes and facilities for safe decontamination. c) By ensuring that there are plans in place for all (General Dental Practitioners) GDP independent contractors to be able to provide LDU facilities within their practices for the decontamination of instruments which are compliant with SHPN 13 Part 2.

March 2014 Head of dental Services/ Locality Managers/ Infection Control Nurses

6.Water Safety 8.1 Ensure Argyll and Bute has robust and consistent arrangements in place for the safety of the water systems in NHS Highland comply with legal duties and relevant guidance

a) By implementing NHS H procedures for the prevention of water-borne infection which include risk assessment, analysis and planned preventative maintenance.

b) By ensuring that daily water flushing is carried out to reduce the risk of water borne infection

March 2014 Estates Manager and Hotel services Managers

Page 64: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

26

7.Domestic Services

7.1 To support Domestic Services to achieve 90% Cleaning compliance.

a) By the development and implementation of Standard Operating Procedures (SOPs), including products used and reports to Senior Charge Nurses b) By the development and implementation of Domestic Services SOPs Training c) By the development and implementation of Domestic Services Standard Monitoring Procedures and Monitoring Training. d) By assessing Domestic Services staffing levels based on the agreed SOPs. e) By monitoring the implementation of COSHH procedures & Risk Assessments.

March 2014 Hotel Services Managers

8. Catering Services

8.1 To support Catering Services & Clinical Staff to ensure food safety from production to delivery.

a) Through education & training such as • Elementary Food Hygiene Certificate • Hazard Analysis and Critical Control Points

(HACCP) Training • Food Service at Ward Level

b) By monitoring compliance with food safety standards.

March 2014 Hotel Services Manager

Page 65: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

Argyll & Bute CHP Committee 21 August 2013

Item : 7.3 Community Planning and Single Outcome Agreement Report by Elaine Garman Public Health Specialist The Committee is asked to: • Note this paper

1 Background and Summary 1.1 In March 2012, the Scottish Government and COSLA jointly issued a Statement of Ambition signalling their agreement that Community Planning Partnerships (CPPs) will be at the heart of public service reform. This statement went on to say: “They [CPPs] will drive the pace of service integration, increase the focus on prevention and secure continuous improvement in public service delivery, in order to achieve better outcomes for communities. Community planning and SOAs will provide the foundation for effective partnership working within which wider reform initiatives, such as the integration of health and adult social care and the establishment of single police and fire services, will happen.” 1.2 The document is clear that Government expects CPPs to: • strengthen their governance, accountability and operating arrangements; • ensure a greater pace of change and decisiveness in impact; • develop new and different ways of working and behaviour within and across partners; • take a more systematic and collaborative approach to performance improvement and

quality standards, including national requirements where appropriate, with robust self-assessment as a starting point.

• to report on progress and performance in ways that are clear to local elected members, CPP partners, local communities, the Scottish Government and audit and inspection bodies.

1.3 The paper goes on to emphasise that the development, delivery and performance management of Single Outcome Agreements (SOAs) are key to this. It requires new SOAs to be developed that:

• Show a clear understanding of place providing a clear and robust link and strong line of sight between that understanding and the priorities, outcomes, and performance commitments set out in the new SOA.

• Plan and deliver for outcomes demonstrating what will be different for communities in

10 years and what will be done to secure those improved outcomes on a rolling 3 year basis.

• Show how the total resource available to the CPP and partners has been

considered and deployed in support of the agreed outcomes • Focus on reducing outcome gaps within populations and between areas i.e.

addressing and reducing inequalities

• Promote early intervention and preventative approaches defined by the national community planning group as, “Actions which prevent problems and ease future demand on services by intervening early, thereby delivering better outcomes and value for money”. Each SOA is to include a specific plan for prevention which demonstrates

Page 66: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

2

commitment to the approach extending beyond any Change Fund type budgets and into mainstream services. The prevention plan is to quantify the resources allocated to prevention and to evidence commitment to increasing them over time.

• Demonstrate genuine community engagement and evidence that the CPP is planning, resourcing and integrating work to support communities to engage and deliver for themselves.

• Focus on national policy priorities by aiming to achieve transformational, not incremental, performance improvement. The six priorities are:

• Economic recovery and growth;

• Employment;

• Early years;

• Safer and stronger communities, and reducing offending;

• Health inequalities and physical activity; and

• Outcomes for older people. 1.4 In March 2013, Audit Scotland published its report into Improving Community Planning

in Scotland. Amongst the key audit findings were that: • CPPs cannot show that they have made a sustained and significant difference in

improving outcomes for their communities and they have not made an impact on reducing social inequality.

• SOAs have not been clear enough about the key improvements that community planning aims to deliver and have lacked clear focus on the added value of CPPs and of partnership working

• There is long way to go before services are truly designed around local communities and the potential of local people to participate in, shape and improve local services is realised.

• Community planning has had little influence over mainstream resources and collective resources are not well known or used.

• CPPs need to get better at managing performance. • CPPs have had weak governance and accountability structures. • CPPs have not been subject to comprehensive external scrutiny to date and this has

contributed to weaknesses in the overall accountability framework for community planning

• The broader public service reform agenda does not appear to be well ‘joined up’ when viewed from a local perspective

1.5 The report makes five groups of recommendations, each reflecting aspects for CPPs

themselves, for The National Community Planning Group, and for The Scottish Government. For CPPs, the recommendations are:

• Strong Shared Leadership: Community planning needs to become a truly shared

enterprise, rather than a council-led exercise. This will mean changes in behaviour and more effective engagement and participation by partners, both executive and non-executive. CPPs need to start acting as true leadership boards, setting a stretching ambitious programme for change and holding people to account for delivering them.

• Governance and accountability: CPPs need to significantly improve their governance

and accountability, and planning and performance management arrangements by successfully mobilising resources towards agreed goals; showing that partnership

Page 67: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

3

working is making a significant difference in improving services and delivering better outcomes for communities; clarifying roles and responsibilities for elected members, non-executives and officers; and ensuring that CPP decision-making is reflected fully within the governance structures of all partners. CPPs need to assure themselves that the proposed arrangements for health and social care integration in their area reflect local circumstances and priorities; are clear about the respective roles and responsibilities of the CPP and H&SCP; will improve the quality of care and outcomes for older people; and will deliver improved value for money.

• Clear priorities for improvement and for use of resources: CPPs need to focus more clearly on where they can make the greatest difference in meeting the complex challenges facing their communities. They need to make their SOAs a true plan for the areas and communities that they serve. They need to show how they are using the significant public money and other resources available to CPP partners to target inequalities and improve outcomes. SOAs need to specify what will improve, how it will be done, by whom, and when. CPPs need to ensure that partners align their service and financial planning arrangements with community planning priorities. This means ensuring that budget setting and business planning decisions by CPP partners such as councils and NHS boards take full account of community planning priorities and SOA commitments.

• Community engagement and empowerment: CPPs need to extend and improve their

approach to engaging with communities if the potential of local people to participate, shape and improve local services is to be realised.

• Improvement support and capacity building: CPPs need to establish effective self-

evaluation arrangements that will allow them to target their local improvement activity (leadership, governance, service delivery, etc) appropriately and demonstrate continuous improvement in their operation. They also need to establish effective arrangements for learning and sharing good practice with each other.

2 Community Planning and the SOA in Argyll & Bute 2.1 A&B CPP has developed a draft SOA (see Appendix 1) and has had a visit from a nationally organised ‘peer review scrutiny panel’ from which written feedback is awaited although we have received initial feedback (see Appendix 2) with regard to the draft SOA prior to the scrutiny visit. 2.2 Each CPP has to undertake a form of self assessment against the Audit Scotland report and the national guidelines for CPPs and SOAs. This is being done following work on the SOA and this will also consider again the Audit Scotland Inequalities report response. 2.3 An action plan to address the issues arising from the self assessment is also required for each CPP. The final SOA is to be agreed and submitted to Scottish Government by 31 March 2014. 2.4 In addition to contributing to the specific health components of the SOA, as part of the Local Delivery Plan (LDP) the CHP illustrated (see Appendix 3) how it is contributing to the six national priorities to improve performance set out in the last bullet point of 1.3 above by providing some examples of their specific contributions to the SOAs for their area, demonstrating how they are contributing to better outcomes through collaborative gain. Scottish Government sees this part of the LDP as a key tool for non-Executive and Executive Board members (see Appendix 4) to exercise oversight and suggest that Boards will want to be sighted on the outcome of the quality assurance of SOAs in their area and in particular the key areas for development and/or improvement arising from the quality assurance process.

Page 68: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

4

2.5 The LDP submission was to be with Government by the end of June, only part way through the national timetable set for SOA development, peer review and partnership improvement, so our submission reflects an interim position. To date, no feedback has been received from Government. 2.6 The next steps for the CHP are to ensure that plans are in place through the Health & Wellbeing Partnership, the public health team and locality clinical teams to deliver on all aspects of the SOA. The process for agreeing performance indicators has not yet been decided within the CPP but preparatory work for that can begin in the CHP. 3 Contribution to Board Objectives The work on the SOA and community planning overall contributes to all three NHS Highland quality objectives (Better Health – improving the health of the population; Better Care – enhancing the experience of care for individuals; and Better Value – controlling the per capita cost of care) 4 Governance Implications • Patient and Public Involvement

Significant community engagement is required to ensure good partnership working for community planning.

• Clinical Governance

Interventions require to be evidence-informed. • Financial Impact

One of the aims of the SOA and community planning generally is to direct mainstream budgets increasingly to tackle inequalities and prevention. All aspects investment and disinvestment will be considered with regard to potential impacts.

5 Risk Assessment No risks are identified at this time. 6 Planning for Fairness There is no requirement to impact assess until specific changes are being suggested to policy or practice. Elaine C Garman Public Health Specialist 2 August 2013

Page 69: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

��

Arg

yll

an

d B

ute

Co

mm

un

ity P

lan

an

d S

ing

le O

utc

om

e A

gre

em

en

t

2013-2

02

3

P

lan

a C

oim

hears

na

ch

d E

arr

a-G

hàid

heal

is B

id

Page 23 7.3i - Appendix 1

Page 70: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

��

� C

ON

TE

NT

S

INT

RO

DU

CT

ION

P

AG

E 3

CO

MM

UN

ITY

PL

AN

NIN

G I

N A

RG

YL

L A

ND

BU

TE

PA

GE

4

UN

DE

RS

TA

ND

ING

AR

GY

LL

AN

D B

UT

E

PA

GE

S 5

-10

PL

AN

NIN

G F

OR

SU

CC

ES

S

PA

GE

S 1

1-2

1

EQ

UA

LIT

IES

P

AG

ES

22

-23

PR

EV

EN

TIO

N P

LA

N

P

AG

ES

24

-25

EN

GA

GE

ME

NT

AN

D E

MP

OW

ER

ME

NT

P

AG

ES

26

-29

RE

SO

UR

CE

S,

PA

RT

NE

RS

HIP

WO

RK

ING

AN

D G

OV

ER

NA

NC

E

P

AG

ES

30

-34

Page 24 7.3i - Appendix 1

Page 71: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

��

�INT

RO

DU

CT

ION

Th

is C

om

mun

ity P

lan

/ S

ingle

Ou

tco

me

Agre

em

en

t 2

013

-202

3 is a

jo

int

sta

tem

en

t fr

om

th

e A

rgyll

an

d B

ute

Com

mu

nity P

lann

ing

Pa

rtn

ers

hip

. It s

ets

ou

t th

e p

art

ne

rsh

ip’s

vis

ion

fo

r a

ch

ievin

g lo

ng t

erm

ou

tcom

es f

or

com

mu

nitie

s in A

rgyll

an

d B

ute

.

The

CP

P r

eco

gn

ise

tha

t th

e c

on

text fo

r d

eliv

erin

g o

utc

om

es is c

ha

llen

gin

g,

with

pu

blic

se

cto

r re

form

, w

elfa

re r

efo

rm a

nd

po

or

eco

no

mic

fo

reca

sts

all

imp

actin

g n

ation

ally

and

lo

ca

lly.

Th

is C

om

mun

ity P

lan

/Sin

gle

Ou

tcom

e A

gre

em

ent

se

ts o

ut

the

vis

ion

, p

rio

ritie

s a

nd

ob

jective

s f

or

Arg

yll

an

d B

ute

ove

r th

e n

ext

ten

ye

ars

.

It a

lso

giv

es t

he

pa

rtners

hip

a fo

cu

s fo

r p

rio

rity

actio

ns a

nd

activitie

s o

ve

r th

e n

ext

thre

e y

ea

rs.

Pla

nn

ing fo

r th

e A

rgyll

an

d B

ute

Com

mu

nity P

lan

an

d S

ingle

Ou

tcom

e A

gre

em

en

t co

mm

en

ce

d in

Ju

ne

20

12

, in

stiga

ted

by t

he

S

co

ttis

h G

ove

rnm

en

t’s d

esire

to

ha

ve

all

Co

mm

un

ity P

lann

ing P

art

ne

rsh

ips d

eve

lop

str

ate

gic

pla

ns in

clo

se c

on

su

lta

tion

with

th

eir

co

mm

un

itie

s.

Th

is is th

e f

irst te

n y

ear

Co

mm

un

ity P

lan

and

Sin

gle

Ou

tcom

e A

gre

em

ent

an

d th

e P

lan

will

be

re

vie

we

d r

egu

larl

y t

o a

sse

ss

pro

gre

ss w

ith

im

ple

men

tation

of

the

pla

n a

nd

als

o t

o e

nsu

re it

still

rem

ain

s r

ele

va

nt

to c

om

mu

nity n

ee

ds.

Ha

vin

g p

art

icip

ate

d in

th

e d

eve

lop

me

nt of

the P

lan

com

mun

itie

s a

re e

ncou

rage

d to

mo

nito

r th

e im

ple

men

tatio

n p

roce

ss b

y v

isitin

g

the

CP

P’’s

we

b s

ite

at h

ttp

://w

ww

.arg

yll-

bu

te.g

ov.u

k/c

ou

ncil-

an

d-g

ove

rnm

en

t/co

mm

un

ity-p

lan

nin

g-p

art

ne

rsh

ip

Co

mm

un

ity p

lann

ing p

art

ne

rs,

the

ir s

taff

, e

lecte

d m

em

be

rs,

an

d m

em

be

rs o

f th

e w

ide

r com

mu

nity a

re to

be

congra

tula

ted

on

th

e

tre

men

do

us jo

int

eff

ort

an

d c

om

mitm

en

t of

tim

e t

ha

t ha

s b

ee

n in

ve

ste

d in

th

e p

repa

ration

of

this

Pla

n.

In te

n y

ea

rs’ tim

e, th

rou

gh

th

e im

ple

men

tatio

n p

roce

ss a

nd

fu

ture

re

vie

ws,

it is h

op

ed

tha

t o

ur

asp

ira

tio

ns w

ill h

ave

co

me

to

fru

itio

n a

nd

ha

ve im

pro

ve

d th

e

qu

alit

y o

f lif

e fo

r com

mu

nitie

s th

rou

gh

ou

t A

rgyll

an

d B

ute

.

��

Page 25 7.3i - Appendix 1

Page 72: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

��

�CO

MM

UN

ITY

PL

AN

NIN

G I

N A

RG

YL

L A

ND

BU

TE

T

he

Arg

yll

an

d B

ute

Co

mm

un

ity P

lan

nin

g P

art

ne

rsh

ip w

as s

et u

p in 2

001

to

coo

rdin

ate

th

e d

eliv

ery

of

se

rvic

es a

nd

oth

er

activitie

s

in A

rgyll

an

d B

ute

to

im

pro

ve

the

qu

alit

y o

f lif

e a

nd

ph

ysic

al e

nviro

nm

ent fo

r re

sid

ents

an

d v

isito

rs t

o t

he

are

a. A

rgyll

an

d B

ute

’s f

irst

Sin

gle

Ou

tcom

e A

gre

em

ent

wa

s a

gre

ed

with

th

e S

co

ttis

h G

ove

rnm

en

t in

Au

gu

st

20

09

an

d c

ove

red

th

ree y

ea

rs, fr

om

20

09

to

20

12,

hig

hlig

htin

g o

utc

om

es to

be a

ch

ieve

d in

tha

t pe

rio

d. T

he

Com

mu

nity P

lan

an

d S

ingle

Ou

tcom

e A

gre

em

en

t 2

012

-20

13

wa

s a

on

e

ye

ar

pla

n w

hic

h b

rou

gh

t u

s to

th

e e

nd

of

the

20

09

-20

13

Com

mu

nity P

lan

tim

efr

am

e.

Th

is te

n y

ea

r p

lan

will

co

ntinu

e to

en

su

re th

at A

rgyll

an

d B

ute

co

ntr

ibu

tes t

o th

e d

eliv

ery

of

the

Go

ve

rnm

en

t’s 1

6 n

ation

al ou

tcom

es

an

d d

eliv

ers

be

tte

r o

utc

om

es f

or

ou

r com

mu

nitie

s.

The

Arg

yll

an

d B

ute

Co

mm

un

ity P

lan

nin

g P

art

ne

rsh

ip is fo

cu

sed

on w

ha

t re

sid

en

ts h

ave

to

ld u

s is m

ost

imp

ort

an

t to

the

m. T

his

C

om

mu

nity P

lan a

nd

Sin

gle

Ou

tcom

e A

gre

em

en

t se

ts o

ut

the

ove

rall

dire

ctio

n a

nd

vis

ion

for

the

are

a u

ntil 20

23 t

oge

the

r w

ith

ou

r a

pp

roa

ch

to

th

e m

ain

issu

es th

at fa

ce A

rgyll

an

d B

ute

. A

ll th

e p

art

ne

rs a

re c

om

mitte

d to

this

te

n y

ea

r p

lan

an

d p

art

ne

rs w

ill r

efle

ct

the

ke

y issu

es in

the

ir o

wn

pla

ns a

s a

pp

rop

ria

te. �

Page 26 7.3i - Appendix 1

Page 73: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

��

�UN

DE

RS

TA

ND

ING

AR

GY

LL

AN

D B

UT

E

Ge

og

rap

hy

Arg

yll

an

d B

ute

is b

oun

ded

by t

he u

rban

are

as o

f H

ele

nsbu

rgh

and D

un

oo

n a

lon

g t

he

Cly

de

, L

och L

om

on

d to

the

Ea

st, th

e M

ull

of

Kin

tyre

to

the

sou

th,

Atla

ntic I

sla

nd

s to

the

we

st,

and

th

e S

oun

d o

f M

ull

an

d A

pp

in to

the

nort

h.

It c

ove

rs a

n a

rea

of

691

,00

0 h

ecta

re

ma

kin

g it

the

se

co

nd

larg

est

loca

l a

uth

ority

are

a in

Sco

tlan

d. O

ur

are

a h

as th

e th

ird

spa

rsest

pop

ula

tion

de

nsity o

f th

e 3

2 S

co

ttis

h

loca

l a

uth

ority

are

as,

with

an a

ve

rage

pop

ula

tio

n d

en

sity o

f ju

st

13 p

ers

on

s p

er

squ

are

kilo

me

tre.

Arg

yll

an

d B

ute

ha

s 2

5 in

hab

ite

d isla

nd

s (

Censu

s 2

00

1)

mo

re th

an

an

y o

the

r lo

ca

l a

uth

ority

in

Sco

tla

nd w

ith

aro

und

17

% o

f th

e

po

pu

latio

n liv

ing o

n I

sla

nd

s (

Cen

su

s 2

001

). T

he

are

a is a

lso

ho

me

to

se

ve

ral lo

ng s

ea lo

chs,

wh

ich

bis

ect

the

land

sca

pe

and

alo

ng

with

th

e isla

nd

s g

ive

Arg

yll

an

d B

ute

a v

ery

lo

ng c

oa

stlin

e a

nd

a h

igh

er

leve

l of

relia

nce

on f

err

ies f

or

tra

ve

l. A

lmost

80

% o

f th

e

po

pu

latio

n liv

e w

ith

in o

ne

kilo

me

tre

of

the

co

ast

(Sco

ttis

h C

oa

sta

l F

oru

m, 2

002

).

The

ma

in s

ett

lem

en

ts te

nd

to

be

at

the

extr

em

ity o

f th

e m

ain

lan

d a

rea

cre

atin

g s

ign

ific

ant p

opu

latio

n d

ispe

rsio

n in

add

itio

n to

lo

w

po

pu

latio

n d

en

sity.

The

pop

ula

tio

n is b

roa

dly

sp

lit b

etw

ee

n t

ho

se

wh

o liv

e in

se

ttle

me

nts

of

3,0

00

or

mo

re p

eop

le (

48

%)

and

th

ose

wh

o liv

e in

se

ttle

men

ts o

f fe

we

r th

an

3,0

00

peo

ple

or

ou

twith

se

ttle

me

nts

alto

ge

the

r (5

2%

) (N

RS

20

11

Mid

-Ye

ar

Estim

ate

s;

SG

U

rba

n-R

ura

l C

lassific

atio

n 2

01

1-

201

2).

T

he

siz

e o

f th

e a

rea

and

pop

ula

tio

n d

isp

ers

ion

re

qu

ire

mu

ltip

le fa

cilt

ies f

or

se

rvic

e d

eliv

ery

to

en

su

re s

erv

ice

s a

re d

eliv

ere

d c

lose

to

u

se

rs a

nd

com

mun

itie

s.

Th

e d

ista

nce

be

twe

en

ma

in s

ett

lem

en

ts a

nd

use

of fe

rry s

erv

ice

s c

rea

te c

ha

llen

ge

s in

te

rms o

f re

liab

ility

a

nd

tim

e a

nd

co

st

of

tra

ve

l. T

he

ge

ogra

ph

y o

f A

rgyll

an

d B

ute

ca

nnot

be

ch

an

ge

d s

o th

e c

ha

llen

ge

is h

ow

to

ma

xim

ise

th

e

ad

va

nta

ge

s it off

ers

and

min

imis

e th

e im

pa

ct of

an

y r

ea

l o

r p

erc

eiv

ed

ob

sta

cle

s.

The

im

po

rtan

ce

of

the

na

tura

l e

nviro

nm

en

t is

in

dic

ate

d b

y t

he 1

21

Site

s o

f S

pe

cia

l S

cie

ntific I

nte

rest

(SN

H,

as a

t D

ece

mb

er

20

12

) th

at h

ave

be

en

de

sig

na

ted w

ith

in t

he

are

a w

hic

h in

to

tal co

ve

r a

lmost

ten p

er

ce

nt of

Arg

yll

an

d B

ute

’s la

nd

are

a. A

dd

itio

na

lly,

alm

ost th

irty

pe

r cen

t of

the L

och

Lo

mo

nd

an

d t

he

Tro

ssa

ch

s N

atio

na

l P

ark

are

a fa

lls w

ith

in t

he

lo

ca

l a

uth

ority

’s b

ou

nd

arie

s

Po

pu

lati

on

an

d D

em

og

rap

hic

s

The

tota

l po

pu

lation

of A

rgyll

an

d B

ute

is 8

8,2

00

ba

se

d o

n t

he

20

11 c

en

su

s. T

his

com

pa

res t

o a

to

tal po

pu

latio

n fo

r th

e a

rea o

f 9

1,3

06

in t

he

20

01 c

ensu

s a

red

uction

of

3.4

%.

Arg

yll

an

d B

ute

was o

ne o

f o

nly

4 lo

ca

l a

uth

ority

are

as to

sh

ow

a d

ecre

ase

in

p

opu

latio

n.

Fu

ture

po

pu

latio

n p

roje

ctio

ns s

ugge

st

a r

edu

ctio

n in

to

tal p

opu

latio

n o

f 7

.2%

fro

m 2

01

0 t

o 2

03

5.

Page 27 7.3i - Appendix 1

Page 74: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

��

� The

cha

nge

in

pop

ula

tio

n f

rom

20

01

to

201

1 is d

iffe

ren

t a

cro

ss t

he

4 a

rea

s o

f A

rgyll

an

d B

ute

as s

et o

ut b

elo

w.

He

len

sb

urg

h a

nd

Lom

on

d -

6.8

%

Bu

te a

nd

Co

wa

l -3

.8%

Mid

Arg

yll,

Kin

tyre

an

d I

sla

y -

1.3

%

Ob

an,

Lo

rn a

nd

th

e Isle

s +

6.8

%

The

de

clin

e in p

op

ula

tio

n e

xp

erie

nce

d to

da

te a

nd t

ha

t p

roje

cte

d in

th

e fu

ture

pre

sen

ts a

sig

nific

ant

ch

alle

nge

to th

e o

ve

rall

via

bili

ty

of

the

are

a. T

his

ch

alle

nge

is m

ad

e m

ore

difficu

lt b

y t

he

va

ria

tio

n in

po

pu

latio

n c

han

ge

s o

ve

r th

e a

rea

s w

ith

in A

rgyll

an

d B

ute

. H

ow

d

oe

s th

e C

PP

bu

ild o

n e

xis

tin

g s

ucce

ss in

are

as t

ha

t ha

ve

actu

al o

r p

ote

ntia

l fo

r gro

wth

wh

ilst

at

the

sam

e t

ime

turn

ing r

ou

nd

th

e

po

sitio

n in

are

as w

he

re d

eclin

e is p

roje

cte

d?

In a

dd

itio

n t

o t

he c

hange

s in

to

tal p

op

ula

tio

n th

e d

em

ogra

ph

ic b

ala

nce

is a

lso

ch

an

gin

g. T

he

tab

le b

elo

w s

ho

ws t

he

ch

an

ge

in

p

opu

latio

n o

ve

r a

ge

coh

ort

s p

roje

cte

d f

or

20

10

and

20

35 a

nd

als

o t

he

ch

an

ge

s in

dem

ogra

ph

ics b

etw

ee

n 2

00

1 a

nd

20

11.

A

ge

Ra

nge

Ch

an

ge

20

01 t

o 2

01

1

Pro

jectio

ns 2

01

0 to

203

5

Un

de

r 15

-16

.6%

-8

.7%

1

5-6

4

-5.2

%

-14

.4%

O

ve

r 6

5

+1

5.0

%

+3

9.7

%

Mo

re p

eo

ple

liv

ing lo

nge

r is

a r

ea

l su

cce

ss. T

he

de

mo

gra

ph

ic c

ha

nge

s d

o h

ow

eve

r cre

ate

a n

um

be

r of

cha

llen

ges.

Th

ese

ch

alle

nge

s r

an

ge

fro

m c

ha

nge

s to

se

rvic

e d

eliv

ery

re

qu

ire

me

nts

fo

r C

PP

pa

rtn

ers

, th

e a

va

ilab

ility

of

pe

op

le to

jo

in t

he

ove

rall

wo

rkfo

rce

in

Arg

yll

an

d B

ute

, a s

ma

ller

poo

l of

pe

op

le c

rea

tin

g w

ea

lth

and

ho

w t

o e

nh

an

ce

th

e e

co

no

mic

or

com

mu

nity c

on

trib

utio

n

ma

de

by p

eo

ple

. E

co

no

my a

nd

Em

plo

ym

en

t A

rgyll

an

d B

ute

’s e

co

no

my is p

red

om

ina

ntly s

erv

ice

-ba

se

d.

Ove

r 8

5%

of

em

plo

ye

e jo

bs in

th

e a

rea

are

pro

vid

ed w

ith

in t

he

se

rvic

e

se

cto

r. 1

4.9

% o

f em

plo

ye

e jo

bs in

Arg

yll

an

d B

ute

are

in t

ou

rism

-re

late

d a

ctivitie

s c

om

pa

red

to

a S

co

ttis

h a

ve

rage

of

8.9

% (

Off

ice

fo

r N

atio

na

l S

tatistics (

ON

S)

An

nu

al B

usin

ess I

nqu

iry e

mp

loye

e a

na

lysis

, 2

00

8 d

ata

(N

OM

IS,

Ma

rch

20

13

)).

Page 28 7.3i - Appendix 1

Page 75: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

��

�Arg

yll

an

d B

ute

ha

s r

ela

tive

ly h

igh

le

ve

ls o

f em

plo

ym

en

t in

agricu

ltu

re, fo

restr

y a

nd f

ish

ing (

6%

co

mp

are

d t

o a

Sco

ttis

h a

ve

rage

of

2%

) a

nd

pub

lic a

dm

inis

tra

tio

n, e

du

ca

tion

an

d h

ea

lth

(3

6%

com

pa

red

to

a S

co

ttis

h a

ve

rage

of

31

%).

Fe

we

r p

eop

le in

Arg

yll

an

d

Bu

te w

ork

in

ma

nufa

ctu

rin

g (

3%

co

mp

are

d t

o a

Scott

ish

ave

rage

of

8%

).

In 2

00

9 t

he

re w

ere

55

,80

0 p

eop

le o

f w

ork

ing a

ge

(m

ale

s a

nd

fem

ale

s a

ge

d 1

6-6

4)

in A

rgyll

an

d B

ute

. O

f th

ese

, 78

% (

42

,40

0)

we

re

eco

no

mic

ally

active

. T

his

pro

po

rtio

n is s

imila

r to

th

e S

co

ttis

h a

ve

rage

of

77

% (

ON

S A

nn

ua

l P

opu

lation

Su

rve

y,

Octo

be

r 2

011

-S

ep

tem

be

r 20

11

da

ta (

NO

MIS

, M

arc

h 2

013

)). W

ith

in t

his

gro

up,

the

ma

jority

of

wo

rke

rs (

59%

) w

ere

em

plo

ye

es.

Ra

tes o

f se

lfe

mp

loym

ent

(12

%)

are

notice

ab

ly h

igh

er

tha

n th

e S

co

ttis

h a

ve

rage

(8

%)

(fig

ure

2).

F

igu

res f

rom

th

e O

NS

An

nua

l P

op

ula

tio

n S

urv

ey (

Octo

be

r 20

11

-Sep

tem

be

r 2

012

(N

OM

IS,

Ma

rch

20

13

)) s

ugge

st

that

Arg

yll

an

d

Bu

te h

as a

slig

htly h

igh

er

pro

po

rtio

n o

f d

ire

cto

rs,

ma

na

ge

rs a

nd

se

nio

r off

icia

ls a

mon

gst

its w

ork

forc

e th

an t

he S

co

ttis

h a

ve

rage

(A

rgyll

an

d B

ute

: 10

.0%

; S

co

tla

nd:

8.3

%).

A r

ela

tive

ly h

igh

pro

po

rtio

n o

f em

plo

ym

en

t in

skill

ed

tra

de

s (

15

% in A

rgyll

an

d B

ute

(O

NS

A

nn

ua

l P

op

ula

tio

n S

urv

ey (

Octo

be

r 20

11

- S

ep

tem

be

r 2

012

(N

OM

IS,

Ma

rch

20

13

)) is d

rive

n b

y t

he

agricu

ltu

ral secto

r. T

he

pro

po

rtio

n o

f p

eo

ple

em

plo

ye

d a

s p

roce

ss,

pla

nt a

nd m

ach

ine

op

era

tive

s is lo

w (

5.6

% in

Arg

yll

an

d B

ute

), in

lin

e w

ith

th

e lo

w

pro

po

rtio

n o

f p

eo

ple

em

plo

ye

d in m

an

ufa

ctu

rin

g.

The

re

lative

ly h

igh

pe

rce

nta

ge

s o

f a

sso

cia

te p

rofe

ssio

na

l a

nd t

ech

nic

al jo

bs in

th

e

Co

mm

ute

r B

elt ide

ntifie

d in

th

e C

en

su

s r

esu

lt f

rom

th

e p

resen

ce

th

e n

ava

l b

ase a

t F

asla

ne,

as s

erv

ice

me

n a

nd

wo

men

fa

ll in

to th

is

gro

up

. G

ross V

alu

e A

dd

ed

is a

n ind

ica

tor

of

we

alth

cre

atio

n a

nd

me

asu

res th

e c

on

trib

utio

n to

th

e e

co

nom

y o

f ea

ch

ind

ivid

ua

l p

rod

uce

r,

ind

ustr

y o

r se

cto

r. O

ve

r re

ce

nt

ye

ars

Arg

yll

an

d B

ute

ha

s w

itn

essed a

n im

pro

ve

me

nt

with

re

ga

rd t

o its

GV

A p

er

em

plo

ye

e f

igu

res.

At

the

Arg

yll

an

d B

ute

lo

ca

l au

tho

rity

are

a le

ve

l ke

y s

ecto

rs s

uch

man

ufa

ctu

rin

g,

co

nstr

uctio

n,

se

rvic

es a

nd

to

urism

are

90

%,

12

3%

, 8

2%

an

d 9

3%

re

sp

ective

ly o

f th

e S

co

ttis

h a

ve

rage

. A

cco

rdin

g t

o th

e A

nn

ua

l S

urv

ey o

f H

ou

rs a

nd E

arn

ings (

AS

HE

) (N

OM

IS,

Ma

y 2

01

2),

in

201

2 th

e a

ve

rage

re

sid

ent

in A

rgyll

an

d

Bu

te e

arn

ed

£4

62

pe

r w

ee

k,

7%

lo

we

r th

an

th

e a

ve

rage

fo

r S

co

tland

. U

ne

mp

loym

en

t ra

tes in

Arg

yll

an

d B

ute

are

be

low

th

e n

atio

na

l a

ve

rage

alth

ou

gh

, be

cau

se o

f th

e h

igh

le

ve

ls o

f sea

so

na

l e

mp

loym

en

t in

the

are

a,

rate

s v

ary

acco

rdin

g t

o t

ime

of

ye

ar.

T

he

re a

re a

num

be

r of

ch

alle

nge

s r

ela

tin

g t

o e

co

no

my a

nd

em

plo

ym

ent.

A h

igh

de

pen

den

ce

on

sea

so

na

l in

du

str

ies r

esu

lts in

man

y

ch

alle

nge

s w

he

re b

y w

ork

ers

ma

y t

ake

mu

ltip

le jo

bs d

urin

g t

he s

um

me

r pe

rio

d to

ma

xim

ise

in

com

e a

nd

lo

ok f

or

oth

er

job

s w

he

n

Page 29 7.3i - Appendix 1

Page 76: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

�the

“sea

so

n”

is o

ve

r o

r co

mm

ute

to

oth

er

are

as t

o s

ee

k e

mp

loym

en

t o

r h

igh

er

ea

rnin

gs.

In g

en

era

l te

rms G

VA

and

in

com

e is lo

we

r th

an t

he

Scott

ish

ave

rage

. T

he

re is a

hig

he

r de

pen

den

cy o

n s

ea

so

na

l in

du

str

ies a

nd

th

e p

ub

lic s

ecto

r th

an

oth

er

are

as.

Arg

yll

an

d B

ute

als

o h

as a

ran

ge

of

opp

ort

unitie

s w

he

re it

po

sse

sses f

acto

rs o

f com

pe

titive

ad

va

nta

ge

th

at w

he

n ta

ke

n in

the

ir

en

tire

ty m

ake

s it a

un

iqu

e lo

ca

l e

co

nom

y a

nd

one

th

at h

as m

uch

to o

ffe

r S

co

tlan

d’s

lon

g-t

erm

eco

no

mic

gro

wth

an

d s

ecu

rity

. T

he

se

in

clu

de

an

ab

un

da

nce o

f su

sta

inab

le e

co

no

mic

asse

ts e

spe

cia

lly in

te

rms o

f re

ne

wa

ble

energ

y,

fore

str

y,

qu

alit

y f

oo

d a

nd

drin

k a

nd

to

urism

, a

nd

its

bo

un

da

ry w

ith

Sco

tla

nd

’s C

en

tra

l B

elt.

Ma

rin

e s

cie

nce

and

cu

ltu

re a

nd

he

rita

ge

are

fu

rthe

r a

rea

s o

f sig

nific

an

t gro

wth

po

ten

tia

l. In

add

itio

n to

pu

rsu

ing g

row

th in

th

ese

ke

y s

ecto

rs it

will

be

im

po

rta

nt

to e

nsu

re th

ere

is a

fo

cu

s o

n s

up

po

rtin

g

exis

tin

g b

usin

esse

s to

gro

w a

s w

ell

as d

eve

lop

ing n

ew

bu

sin

esse

s.

De

ve

lop

men

t of

the

eco

nom

y a

nd

em

plo

ym

en

t w

ill r

equ

ire

in

ve

stm

en

t to

en

su

re infr

astr

uctu

re is n

ot

a b

arr

ier

to g

row

th a

nd

th

at

su

ppo

rt f

or

ed

uca

tio

n, skill

s a

nd

tra

inin

g c

rea

tes t

he

con

ditio

ns t

o d

eve

lop

an

ap

pro

pria

tely

skill

ed

an

d e

xp

erie

nced

wo

rkfo

rce

. D

ep

riva

tio

n

The

Sco

ttis

h In

de

x o

f M

ultip

le D

ep

riva

tio

n (

SIM

D),

pro

du

ced

by t

he

Sco

ttis

h G

ove

rnm

en

t, id

en

tifie

s s

ma

ll-a

rea

con

ce

ntr

atio

ns o

f m

ultip

le d

ep

riva

tio

n a

cro

ss S

co

tlan

d. T

he

SIM

D is p

rod

uced

at d

ata

zo

ne

le

ve

l. T

he

re a

re 6

505

da

tazo

ne

s in

Sco

tla

nd

and

12

2

da

tazo

ne

s a

re in

Arg

yll

an

d B

ute

. T

he

re

su

lts f

or

Arg

yll

an

d B

ute

fro

m t

he

SIM

D 2

012

sho

w

10

da

tazo

ne

s in

Arg

yll

an

d B

ute

in

th

e 1

5%

mo

st

ove

rall

dep

rive

d d

ata

zo

ne

s.

9 d

ata

zo

ne

s a

re in

th

e 1

5%

mo

st in

com

e d

ep

rive

d d

ata

zo

ne

s.

8 d

ata

zo

ne

s a

re in

th

e 1

5%

mo

st em

plo

ym

en

t d

ep

rive

d d

ata

zo

ne

s.

12

da

tazo

ne

s a

re in

the

15

% m

ost h

ea

lth

de

pri

ve

d d

ata

zo

ne

s.

41

,73

8 p

eop

le liv

e in

th

e 5

3 d

ata

zo

ne

s (

43

%)

tha

t a

re a

mon

gst

the

15

% m

ost a

cce

ss d

ep

rive

d d

ata

zo

ne

s.

13

of

Arg

yll

an

d B

ute

’s d

ata

zo

ne

s –

mo

re t

han

10

% –

are

in

th

e 1

% m

ost a

cce

ss d

ep

rive

d d

ata

zo

ne

s .

The

mo

st a

cce

ss d

ep

rive

d d

ata

zo

ne in

Sco

tlan

d c

ove

rs t

he

isla

nd

s o

f C

oll

and

Tire

e.

All

of

the

da

tazo

ne

s t

ha

t a

re in

the

15

% m

ost O

ve

rall,

In

com

e, E

mp

loym

en

t a

nd H

ea

lth

dep

rive

d d

ata

zo

ne

s in

Sco

tla

nd

are

in

ou

r m

ain

to

wn

s.

Co

nve

rse

ly,

Acce

ss D

ep

riva

tio

n is m

ost p

ron

oun

ce

d in

ou

r ru

ral a

rea

s.

Page 30 7.3i - Appendix 1

Page 77: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

�De

priva

tio

n d

oe

s e

xis

t in

its

va

rio

us f

orm

s in

Arg

yll

an

d B

ute

. W

he

re it

rela

tes t

o in

com

e, e

mp

loym

en

t a

nd

he

alth

it

ten

ds to

be

d

isp

ers

ed in

sm

all

conce

ntr

ation

s in

ou

r m

ain

to

wn

s.

Giv

en

th

e d

ispe

rse

d n

atu

re o

f A

rgyll

an

d B

ute

th

is c

rea

tes c

ha

llen

ge

s in

id

en

tify

ing a

nd

ad

dre

ssin

g d

ep

riva

tio

n a

nd

its

ca

use

s.

It is c

lea

r th

at in

equ

alit

ies d

o e

xis

t w

ith

in

Arg

yll

an

d B

ute

and

the

CP

P m

ust

pla

n to

ad

dre

ss th

ese

. H

ea

lth

P

hysic

al in

activity is a

sig

nific

an

t h

ea

lth

issue n

ation

ally

an

d in A

rgyll

an

d B

ute

. It c

ontr

ibu

tes t

o m

an

y lo

ng t

erm

he

alth

co

nd

itio

ns

su

ch

as C

HD

, d

iabe

tes a

nd s

om

e c

an

ce

rs, a

s w

ell

as o

ve

rwe

igh

t a

nd

hig

h b

loo

d p

ressu

re. T

he

re a

re s

tro

ng lin

ks b

etw

ee

n

incre

ase

d p

hysic

al a

ctivity le

ve

ls a

nd

im

pro

ve

d m

en

tal w

ellb

ein

g.

Me

nta

l he

alth

pro

ble

ms a

re v

ery

co

mm

on

in

Sco

tla

nd

with

one

in

4 p

eop

le e

xp

erie

ncin

g the

m d

urin

g t

he

ir lifetim

e.

Th

is h

as a

sig

nific

an

t im

pa

ct o

n loca

l a

rea

s a

nd

eco

nom

ies, fo

r e

xa

mp

le w

ork

lessn

ess a

nd

dem

an

d for

he

alth

ca

re s

erv

ice

s. T

he

World

He

alth

O

rga

nis

atio

n r

eco

gn

ise

s t

he

im

po

rtan

ce

of

me

nta

l h

ea

lth

im

pro

ve

me

nt a

nd s

tate

s “

the

re c

an

be

no

he

alth w

ith

out

me

nta

l h

ea

lth

”.

In 2

01

1 it

wa

s e

stim

ate

d t

he

re w

ere

77

0 p

rob

lem

dru

g u

se

rs in

Arg

yll

& B

ute

wh

ich

wa

s a

40

% in

cre

ase

fro

m 2

006

. S

tatistics o

n

the

use

of

alc

oh

ol a

mon

gst

yo

un

g p

eo

ple

in

Arg

yll

& B

ute

sho

w t

ha

t th

ere

is a

hig

he

r th

an

ave

rage

exp

erim

en

tation

and

use

of

alc

oh

ol th

an

the

re

st of

Sco

tlan

d.

De

ath

ra

tes d

rugs a

nd

alc

oho

l lo

we

r th

an

ave

rage

L

ife

exp

ecta

ncy 7

5.8

an

d 8

0.4

is a

bo

ve

Sco

ttis

h a

ve

rage

74

.5 a

nd

79

.5. O

ur

he

alth

y life

exp

ecta

ncy is 6

8.5

ye

ars

(m

ale

s)

an

d 7

2.5

ye

ars

(fe

ma

les)

com

pare

d t

o th

e S

cott

ish

ave

rage

of

66

.3 (

ma

les)

an

d 7

0.2

(fe

ma

les)

(1999

-20

03

; S

co

tPH

O).

E

du

ca

tio

n

The

ed

ucatio

na

l a

tta

inm

ent

in A

rgyll

an

d B

ute

is a

bo

ve

th

e n

atio

na

l a

ve

rage

in

mo

st m

ea

su

res a

nd

in

201

1-1

2,

90

.1%

of

scho

ol

lea

ve

rs a

ch

ieve

d a

po

sitiv

e a

nd

su

sta

ined

de

stin

ation

. S

ch

oo

ls in

cre

asin

gly

off

er

acce

ss to

a r

an

ge

of

wid

er

qu

alif

ica

tio

ns to

assis

t p

up

ils w

ith

vo

ca

tio

na

l ro

ute

s p

rovid

ing a

cce

ss t

o F

E/H

E c

ou

rse

s in

sch

oo

ls. A

tota

l of

56

3 p

up

ils a

cce

sse

d s

kill

s f

or

wo

rk t

hro

ugh

2

0 c

ou

rse

s in

201

2-1

3 w

ith

1,4

91

pu

pils

accessin

g w

ide

r qu

alif

ica

tion

s t

hro

ugh

31 c

ou

rse

s in

201

2-1

3.

At le

ast 2

40

adu

lts p

er

qu

art

er

(ap

pro

x.

0.2

6%

of

the

po

pu

lation

) a

cce

ss a

du

lt le

arn

ing n

etw

ork

se

rvic

e p

rovis

ion

acro

ss A

rgyll

an

d B

ute

T

he

cha

llen

ge

is to

ensu

re w

e c

an

cre

ate

opp

ort

un

itie

s t

o r

eta

in a

nd

en

co

ura

ge

yo

un

g p

eo

ple

to

fu

rth

er

the

ir e

du

ca

tion

, de

ve

lop

skill

s a

nd

bu

ild c

are

ers

, b

usin

ess a

nd

fu

lfill

ing liv

es in

Arg

yll

an

d B

ute

.

Page 31 7.3i - Appendix 1

Page 78: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

���

� Ou

r C

ha

lle

ng

es

The

ke

y c

ha

llen

ge

s w

e f

ace

re

late

to

:

Ou

r g

eo

gra

ph

y –

A h

igh

ly r

ura

l a

rea

with

man

y s

ma

ll com

mu

nitie

s, oft

en

sep

ara

ted

by w

ate

r. A

cce

ss to

th

e a

rea

an

d to

ke

y

se

rvic

es a

re p

ere

nn

ial ch

alle

nge

s.

Re

du

cin

g p

op

ula

tio

n –

Th

e p

roje

cte

d d

eclin

e in

to

tal p

opu

lation

is a

re

al th

rea

t to

th

e v

iab

ility

of

the

are

a w

ith

a p

ote

ntia

l to

a

dve

rse

ly im

pa

ct

on

the

econ

om

y/w

ea

lth

cre

atio

n, w

ork

forc

e a

va

ilab

ility

an

d e

ffic

ien

t se

rvic

e d

eliv

ery

.

Ch

an

gin

g p

op

ula

tio

n –

With

mo

re e

xtr

em

es t

han

mo

st of

Sco

tlan

d a

nd

th

e d

iffe

ren

ce

s a

re g

ett

ing g

rea

ter

we

fa

ce

in

cre

asin

g c

osts

an

d c

ha

llen

ge

s to

de

live

r se

rvic

es t

o o

lde

r p

eo

ple

an

d th

e n

ee

d to

en

coura

ge

yo

un

ge

r p

eo

ple

to

mo

ve

to

th

e a

rea

so

tha

t o

ur

eco

nom

y c

an

gro

w

Ec

on

om

y –

Un

lockin

g t

he

opp

ort

un

itie

s o

ffe

red

by its

sig

nific

an

t, s

usta

inab

le e

co

nom

ic a

sse

ts f

or

the

ben

efit of

its

co

mm

un

itie

s a

nd

th

e c

om

pe

titive

ne

ss a

nd s

ecu

rity

of

the

Sco

ttis

h a

nd

EU

eco

no

mie

s.

Em

plo

ym

en

t –

De

ve

lop

ing e

du

ca

tio

n,

skill

s a

nd

tra

inin

g t

o m

axim

ise

opp

ort

un

itie

s fo

r a

ll an

d c

reate

a w

ork

forc

e to

su

pp

ort

e

co

no

mic

gro

wth

.

Infr

as

tru

ctu

re –

Im

pro

vin

g a

nd

ma

kin

g b

ette

r u

se

of

infr

astr

uctu

re in o

rde

r to

pro

mote

th

e c

on

ditio

ns f

or

econ

om

ic g

row

th

inclu

din

g e

nh

an

cin

g t

he

bu

ilt e

nviro

nm

en

t.

Su

sta

ina

bilit

y –

En

su

rin

g a

su

sta

ina

ble

fu

ture

by p

rote

ctin

g t

he

na

tura

l e

nviro

nm

en

t a

nd m

itig

atin

g c

lima

te c

hange

.

He

alt

h –

Imp

rovin

g h

ealth

and

we

ll b

ein

g a

nd

re

du

cin

g h

ea

lth

ine

qu

alit

ies.

De

pri

va

tio

n –

Ine

qu

alit

ies e

xis

t in

Arg

yll

an

d B

ute

so

we

nee

d to

im

pro

ve

ho

w w

e id

en

tify

an

d im

ple

men

t a

ctio

n to

add

ress

them

.

Pe

op

le o

n t

he f

rin

ge

– M

an

y o

f ou

r com

mu

nitie

s a

re v

ery

iso

late

d a

nd

ris

k c

olla

psin

g a

s p

op

ula

tio

n c

ha

nge

s ta

ke

aff

ect

alo

ngsid

e u

rba

n c

om

mu

nitie

s w

he

re d

ep

riva

tio

n c

an

cre

ate

rea

l h

ard

sh

ips

Page 32 7.3i - Appendix 1

Page 79: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

���

�PL

AN

NIN

G F

OR

SU

CC

ES

S

Ove

rall

Ob

jec

tive

T

he

evid

en

ce

co

llate

d in

und

ers

tan

din

g A

rgyll

an

d B

ute

se

ts o

ut

a c

lea

r th

reat

to t

he

futu

re s

ucce

ss o

f th

e a

rea

. W

hils

t th

ere

are

a

ran

ge

of

so

cia

l an

d c

om

mu

nity c

ha

llen

ge

s b

y f

ar

the

mo

st

sig

nific

ant

ch

alle

nge

fa

cin

g t

he

are

a r

ela

tes to

th

e e

con

om

y a

nd

p

opu

latio

n.

Un

less th

ese

sp

ecific

issue

s a

re a

dd

resse

d th

e s

co

pe

an

d c

ap

acity t

o a

dd

ress s

om

e o

f th

e o

the

r ch

alle

nge

s f

acin

g

Arg

yll

an

d B

ute

will

be

gre

atly r

ed

uce

d. T

he

re is a

cle

ar

ch

oic

e b

etw

ee

n m

an

agin

g d

eclin

e a

nd

co

mm

ittin

g to

cre

atin

g a

virtu

ou

s

circle

ba

se

d a

roun

d s

tab

ilisa

tio

n a

nd

gro

wth

of

the

eco

no

my a

nd

pop

ula

tion

le

ad

ing t

o im

pro

ve

d s

ocia

l a

nd

com

mu

nity f

acto

rs.

The

ove

rall

ob

jective

of

the S

OA

fo

r th

e 1

0 y

ea

rs t

o 2

023

is -

Arg

yll

an

d B

ute

’s e

co

no

mic

su

cce

ss i

s b

uilt

on

a g

row

ing

p

op

ula

tio

n.

Th

is o

utc

om

e is e

ntire

ly s

up

po

rtiv

e o

f th

e 6

na

tio

na

l p

olic

y p

rio

ritie

s s

et

ou

t in

th

e n

atio

na

l gu

ida

nce

on

co

mm

un

ity p

lan

nin

g a

nd w

ill

als

o s

ee

Arg

yll

an

d B

ute

co

ntr

ibu

te t

o th

e n

atio

na

l o

utc

om

es f

or

Sco

tla

nd

. L

on

g T

erm

Ou

tco

mes

T

o a

ch

ieve

th

e o

ve

rall

ob

jective

se

t o

ut a

bo

ve

6 lo

ng te

rm o

utc

om

es h

ave

be

en

ide

ntified

. T

he

se

ou

tco

me

s w

ill s

up

po

rt th

e o

ve

rall

ob

jective

of

“Arg

yll

an

d B

ute

’s e

con

om

ic s

ucce

ss is b

uilt

on

a g

row

ing p

op

ula

tio

n”

an

d a

lso

ad

dre

ss th

e 6

na

tion

al p

olic

y p

rio

ritie

s

for

com

mu

nity p

lann

ing.

Th

e 6

lon

g t

erm

outc

om

es a

re s

et o

ut b

elo

w.

In A

rgyll

an

d B

ute

:

The

eco

nom

y is d

ive

rse

and

th

rivin

g.

We h

ave

infr

astr

uctu

re t

ha

t su

pp

ort

s s

usta

inab

le g

row

th.

Ed

ucatio

n, skill

s a

nd t

rain

ing m

axim

ise

s o

pport

un

itie

s fo

r a

ll.

Ch

ildre

n a

nd

yo

un

g p

eo

ple

ha

ve

th

e b

est

po

ssib

le s

tart

.

Pe

op

le liv

e a

ctive

, h

ea

lth

ier

and

ind

epe

nde

nt liv

es.

Pe

op

le liv

e in

safe

r a

nd

str

on

ge

r com

mu

nitie

s.

To a

ch

ieve

ea

ch

of

the 6

lo

ng te

rm o

utc

om

es w

ill r

equ

ire

sig

nific

ant co

mm

itm

en

t a

nd

eff

ort

by a

ll p

art

ne

rs a

nd

als

o f

rom

the

wh

ole

of

Arg

yll

an

d B

ute

. T

he a

pp

roa

ch

fo

r ea

ch

long t

erm

ou

tcom

e w

ill b

e:

Page 33 7.3i - Appendix 1

Page 80: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

���

De

ve

lop

a c

lea

r p

olic

y a

nd

str

ate

gy f

or

the o

utc

om

e.

Ide

ntify

th

e a

ctio

ns th

at

are

re

qu

ire

d.

Pre

pa

re d

eliv

ery

pla

ns t

ha

t a

re c

lea

r a

roun

d r

eso

urc

es a

nd

ris

ks.

Ide

ntify

th

e s

ucce

ss m

ea

su

res a

nd

mile

sto

nes.

Allo

ca

te r

esp

on

sib

ility

to

pa

rtn

ers

so t

he

re is c

lea

r lin

e o

f sig

ht.

Th

is a

pp

roa

ch

will

be

ba

cke

d u

p b

y P

lan

, D

o, C

he

ck,

Act cycle

to

ensu

re p

rogre

ss is m

on

ito

red

, le

sso

ns a

re lea

rne

d a

nd

pla

ns a

nd

p

roce

du

res u

pd

ate

d.

Pe

rfo

rma

nce w

ill b

e m

an

age

d q

ua

rte

rly a

nd

an

nu

ally

an

d a

lso

ove

r th

e 1

0 y

ea

r pe

rio

d o

f th

e S

OA

. P

erf

orm

an

ce

sco

reca

rds w

ill b

e

use

d. O

n a

qu

art

erly b

asis

pe

rfo

rman

ce

will

be

mo

nito

red

to

asse

ss w

he

the

r a

ction

s h

ave

be

en

ta

ke

n o

r m

ilesto

ne

s r

ea

che

d a

nd

th

ere

ma

y b

e a

n e

mp

ha

sis

on

in

pu

t m

ea

su

res o

r sim

ply

th

at

thin

gs h

ave

be

en

do

ne

bu

t a

ll re

late

d t

o th

e lo

ng t

erm

ou

tcom

es.

An

nua

lly p

erf

orm

an

ce

will

be

asse

ssed

in

te

rms w

ha

t im

pa

ct is

th

is a

ctivity h

avin

g b

ase

d o

n p

erf

orm

an

ce

mea

su

res d

eve

lope

d a

s

pa

rt o

f d

eta

iled p

lan

nin

g a

nd

th

is is lik

ely

to

be

mo

re o

utp

ut fo

cu

ssed

but

rela

ted

to

Arg

yll

an

d B

ute

an

d th

e lo

ng te

rm o

utc

om

es.

Ove

r th

e 1

0 y

ea

r lif

etim

e o

f th

e S

OA

th

e n

atio

na

l o

utc

om

e in

dic

ato

rs a

nd o

the

r na

tio

na

l in

dic

ato

r sets

will

be

used

to

asse

ss lo

ng

term

pro

gre

ss a

nd a

lso t

he

co

mp

ara

tive

pe

rform

an

ce

of

Arg

yll

an

d B

ute

– t

his

will

asse

ss t

he

issu

e o

f “s

o w

ha

t d

iffe

ren

ce

is th

is

ma

kin

g?

”.

The

na

tio

na

l gu

ida

nce

on

com

mu

nity p

lan

nin

g s

et

ou

t 6

na

tion

al po

licy p

rio

ritie

s f

or

com

mu

nity p

lan

nin

g. T

he

se w

ere

:

Eco

nom

ic r

eco

ve

ry a

nd

gro

wth

;

Em

plo

ym

en

t;

Ea

rly y

ea

rs;

Safe

r a

nd s

tro

nge

r com

mu

nitie

s,

and

red

ucin

g o

ffen

din

g;

He

alth

ine

qu

alit

ies a

nd p

hysic

al a

ctivity;

an

d

Ou

tcom

es fo

r o

lde

r peo

ple

.

Page 34 7.3i - Appendix 1

Page 81: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

���

�The

tab

le b

elo

w s

ho

ws h

ow

th

e 6

lo

ng t

erm

ou

tcom

es c

on

trib

ute

to

th

e n

atio

na

l p

rio

ritie

s for

co

mm

un

ity p

lan

nin

g.

Arg

yll

an

d B

ute

Lo

ng

Te

rm O

utc

om

es

Re

late

s t

o N

ati

on

al

Po

lic

y P

rio

riti

es

The

eco

nom

y is d

ive

rse

and

th

rivin

g

E

co

nom

ic r

eco

ve

ry a

nd

gro

wth

an

d E

mp

loym

en

t;

We h

ave

infr

astr

uctu

re t

ha

t su

pp

ort

s s

usta

inab

le g

row

th.

E

co

nom

ic r

eco

ve

ry a

nd

gro

wth

Ed

ucatio

n, skill

s a

nd t

rain

ing m

axim

ise

s o

pport

un

itie

s fo

r a

ll.

E

co

nom

ic r

eco

ve

ry a

nd

gro

wth

an

d E

mp

loym

en

t;

Ch

ildre

n a

nd

yo

un

g p

eo

ple

ha

ve

th

e b

est

po

ssib

le s

tart

.

Ea

rly y

ea

rs a

nd

He

alth in

equ

alit

ies a

nd

ph

ysic

al a

ctivity

Pe

op

le liv

e a

ctive

, h

ea

lth

ier

and

ind

epe

nde

nt liv

es.

Ou

tcom

es fo

r o

lde

r peo

ple

an

d H

ea

lth in

equa

litie

s a

nd

ph

ysic

al

activity

Pe

op

le liv

e in

safe

r a

nd

str

on

ge

r com

mu

nitie

s.

S

afe

r a

nd s

tro

nge

r com

mu

nitie

s,

and

red

ucin

g o

ffen

din

g

Fu

rth

er

de

tail

on

ea

ch

lo

ng t

erm

outc

om

e in

clu

din

g o

ur

vis

ion

of

su

cce

ss in

10

ye

ars

are

se

t ou

t on

th

e p

age

s t

hat fo

llow

.

Page 357.3i - Appendix 1

Page 82: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

���

�Lo

ng

Te

rm O

utc

om

e -

In

Arg

yll

an

d B

ute

th

e e

co

no

my i

s d

ive

rse

an

d t

hri

vin

g

Wh

at

su

cc

es

s w

ill

be l

ike i

n 1

0 y

ea

rs

Th

rivin

g b

roa

d b

ase

d e

co

nom

y t

ha

t h

as r

ea

lise

d its

fu

ll co

ntr

ibu

tion

to

Sco

tla

nd

’s e

con

om

ic d

eve

lopm

ent

via

th

e g

row

th in

se

cto

rs

su

ch

as r

en

ew

ab

les, to

urism

, fo

od a

nd

drin

k, m

arin

e s

cie

nce a

nd

dig

ita

l kn

ow

led

ge

eco

nom

y.

He

len

sbu

rgh

and

Lo

mo

nd

will

be

a

thrivin

g lo

ca

l e

co

nom

y b

ased

on a

gro

win

g e

mp

loym

en

t ba

se

and

fu

rth

er

inte

gra

tio

n w

ith

th

e w

ide

r w

est

of

Sco

tla

nd

la

bou

r m

ark

et. T

he

op

po

rtu

nitie

s a

nd

po

ten

tia

l fo

r gro

wth

in

Ob

an

an

d L

orn

are

be

ing d

eve

lop

ed

an

d r

ea

lised

. R

ege

ne

ratio

n a

ctivity in

D

un

oon

an

d R

oth

esa

y h

as t

ran

sfo

rme

d t

he

m in

to

th

rivin

g lo

ca

l e

co

no

mie

s. T

he s

ucce

ss o

f C

am

pb

elto

wn

/ M

ach

rih

an

ish N

RIP

site

is

ke

y t

o e

nsu

rin

g t

he

lo

ca

l e

co

nom

y h

as a

susta

inab

le f

utu

re. O

ve

rall

incre

ase

d le

ve

ls o

f in

co

me a

nd

em

plo

ym

en

t.

Th

is i

s t

he p

rog

ress

we e

xp

ec

t to

mak

e in

3 y

ea

rs

Co

ntr

ibu

tion

an

d r

ole

of

Arg

yll

an

d B

ute

to

th

e G

ove

rnm

en

t E

co

no

mic

Str

ate

gy is u

nd

ers

tood

and

fu

lly s

up

po

rted

by n

atio

na

l an

d

regio

na

l a

ge

ncie

s. G

row

ing o

pp

ort

un

itie

s fo

r o

nsho

re a

nd

off

sho

re r

en

ew

ab

le e

ne

rgy t

hro

ugh

ou

t A

rgyll

an

d B

ute

an

d a

n a

ctive

lo

ca

l su

pp

ly c

ha

in f

ocuse

d a

rou

nd

the

Cam

pbe

lto

wn

/ M

ach

rih

an

ish

NR

IP s

ite

an

d o

ppo

rtun

itie

s a

rou

nd N

ort

h A

rgyll.

Eu

rop

ean

M

arin

e S

cie

nce

Pa

rk o

ccu

pie

d a

nd

a g

row

ing

clu

ste

r of

edu

ca

tio

n,

rese

arc

h a

nd

com

me

rcia

l a

ctivity a

t D

un

sta

ffna

ge

with

futu

re

ph

ase

s w

ell

ad

va

nce

d. R

ep

ositio

nin

g t

he A

rgyll

an

d B

ute

tou

rism

pro

du

ct a

nd

pro

file

, in

cre

asin

gly

active

ne

two

rks e

sta

blis

he

d,

cre

atin

g n

ew

to

urism

exp

erie

nce

s,

drivin

g u

p a

dde

d v

alu

e lo

ca

lly,

rais

ing t

he

qu

alit

y o

f th

e a

cco

mm

od

atio

n a

cro

ss t

he

are

a. A

cle

ar

str

ate

gic

an

d h

olis

tic focu

s o

n t

he

re

ge

ne

ration

ch

alle

nge

s in

Dun

oon

and

Ro

the

sa

y w

ill b

egin

to

sh

ow

po

sitiv

e r

esu

lts w

ith

o

ppo

rtu

nitie

s t

hro

ugh

im

pro

ve

d c

on

ne

ctivity b

ein

g r

ea

lise

d,

incre

asin

g a

ctivity in

th

e h

ou

sin

g m

ark

et a

nd in

wa

rd in

ve

stm

en

t su

cce

sse

s. T

he

de

live

ry o

f a r

an

ge

of

pu

blic

an

d p

riva

te s

ecto

r in

ve

stm

en

ts in

th

e H

ele

nsb

urg

h a

nd

Lo

mo

nd

are

a h

as e

nco

ura

ge

d

furt

he

r e

co

no

mic

de

ve

lop

me

nt a

nd

in

ve

stm

ent

opp

ort

un

itie

s th

at a

re s

ign

ific

an

t a

t th

e r

egio

na

l le

ve

l a

nd t

ha

t ra

ises t

he

are

a’s

p

rofile

. B

usin

ess a

nd

co

mm

erc

ial op

po

rtu

nitie

s a

re p

rom

ote

d a

cro

ss a

ll co

mm

un

itie

s in

Arg

yll

an

d B

ute

and

op

po

rtu

nitie

s r

ela

tin

g t

o

ke

y s

ecto

rs s

uch

as tou

rism

, th

e d

igita

l e

co

no

my, fo

od

an

d d

rin

k (

incl. w

his

ky)

an

d r

en

ew

ab

les a

re b

ein

g e

xp

loited

by lo

ca

l b

usin

esse

s.

Th

is i

s w

he

re w

e a

re n

ow

T

he

bu

sin

ess b

ase

rem

ain

s n

arr

ow

an

d th

e p

ub

lic s

ecto

r is

do

min

an

t. A

cce

ss t

o f

inan

ce

an

d a

la

ck o

f confid

en

ce a

re a

ctin

g a

s a

b

rake

on

bu

sin

ess in

ve

stm

en

t. L

ow

le

ve

ls o

f re

se

arc

h a

nd

de

ve

lop

me

nt a

ctivity.

Un

em

plo

ym

ent

is a

bo

ve

the

re

gio

na

l a

ve

rage

. H

igh

le

ve

l o

f se

lf e

mp

loym

en

t a

nd p

ropo

rtio

n o

f m

icro

bu

sin

esse

s w

ith

fe

w b

usin

esse

s o

f sca

le.

Th

es

e a

re t

he

ke

y s

tra

teg

ies a

nd

de

live

ry p

lan

s

A s

epa

rate

str

ate

gy f

or

eco

no

mic

re

co

ve

ry a

nd

gro

wth

is b

ein

g d

eve

lop

ed

tha

t w

ill s

et

ou

t ho

w t

he

CP

P p

lan

s to

take

th

is fo

rwa

rd.

Th

is w

ill s

up

ple

me

nt

exis

tin

g p

lan

s a

nd

co

mm

itm

en

ts f

rom

Hig

hla

nd

s a

nd

Isla

nd

s E

nte

rprise

Ope

ratin

g P

lan a

nd

th

e C

ou

ncil’

s

Page 36 7.3i - Appendix 1

Page 83: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

���

�Eco

nom

ic D

eve

lopm

en

t A

ction

Pla

n a

nd

Re

ne

wa

ble

En

erg

y A

ctio

n P

lan

an

d th

e w

ork

of

the

Bu

sin

ess G

ate

wa

y t

ea

m. E

xis

tin

g

pa

rtn

ers

hip

s a

rou

nd r

en

ew

ab

le e

ne

rgy (

Arg

yll

an

d B

ute

Ren

ew

ab

les A

llia

nce

) an

d to

urism

(A

rgyll

an

d t

he I

sle

s S

tra

tegic

To

urism

P

art

ne

rsh

ip)

will

be

su

pp

lem

ente

d b

y o

the

r se

cto

r spe

cific

pa

rtn

ers

hip

s a

nd

en

ha

nced

enga

ge

me

nt

with

the

bu

sin

ess c

om

mu

nity a

t a

lo

ca

l le

ve

l a

nd

Arg

yll

an

d B

ute

wid

e t

o e

nsu

re w

e c

rea

te th

e r

igh

t co

nd

itio

ns f

or

econ

om

ic g

row

th.

Th

es

e a

re s

om

e o

f th

e m

ain

are

as

of

foc

us i

nc

lud

ed

wit

hin

th

is o

utc

om

e

Bu

sin

ess g

row

th,

su

sta

ina

bili

ty a

nd

sta

rt u

p. D

eve

lop

men

t of

spe

cific

se

cto

rs –

tou

rism

, m

arin

e s

cie

nce

, re

ne

wa

ble

s,

dig

ita

l e

co

no

my,

cu

ltu

re a

nd

he

rita

ge

, fo

od a

nd

drink a

nd t

rad

itio

na

l se

cto

rs.

Page 37 7.3i - Appendix 1

Page 84: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

���

�Lo

ng

Te

rm O

utc

om

e –

We

ha

ve

in

fra

str

uc

ture

th

at

su

pp

ort

s s

usta

ina

ble

gro

wth

. W

ha

t s

ucc

es

s w

ill

be l

ike i

n 1

0 y

ea

rs

Lo

ng t

erm

str

ate

gic

infr

astr

uctu

re p

lann

ing u

nd

ert

aken

in

pa

rtne

rsh

ip w

ith

th

e S

cott

ish

Go

ve

rnm

en

t an

d th

e p

riva

te s

ecto

r ha

s

imp

rove

d A

rgyll

& B

ute

’s r

oa

d,

rail,

fe

rry,

air a

nd

wid

er

tra

nspo

rta

tion infr

astr

uctu

re t

o s

upp

ort

th

e g

row

th o

f o

ur

eco

nom

y a

nd

th

e

su

sta

ina

bili

ty o

f o

ur

com

mu

nitie

s.

The

de

ve

lop

me

nt of

the e

lectr

ical tr

an

sm

issio

n a

nd

dis

trib

utio

n g

rid

ha

s b

ee

n s

tre

ngth

ene

d to

su

ppo

rt t

he

con

tin

ue

d d

eve

lop

me

nt of

ren

ew

ab

le te

ch

no

logy a

nd

to p

rovid

e a

dd

itio

na

l com

mu

nity r

esili

en

ce

. T

he

wa

ter

utilit

y

infr

astr

uctu

re c

ontin

ues t

o b

e d

eve

lop

ed in

bo

th o

ur

tow

n a

nd

ru

ral a

rea

s to

sup

po

rt e

con

om

ic d

eve

lopm

en

t a

nd h

ou

sin

g.

In

te

n

ye

ars

, A

rgyll

an

d B

ute

will

ha

ve

wo

rld

cla

ss d

igita

l a

nd

mob

ile infr

astr

uctu

re th

at p

rom

ote

s s

usta

ina

ble

eco

no

mic

de

ve

lop

me

nt,

co

mm

un

ity r

esili

en

ce

an

d s

erv

ice

de

live

ry a

nd

ma

ke

s A

rgyll

& B

ute

a m

ore

com

pe

llin

g p

lace

to

liv

e a

nd

wo

rk.

Inve

stm

en

t in

h

ou

sin

g a

nd

co

mm

un

ity f

acili

tie

s s

upp

ort

su

sta

ina

ble

econ

om

ic g

row

th a

nd

alo

ng w

ith

re

ge

ne

ration

of

ou

r to

wn

cen

tre

s a

nd

bu

ilt

en

viro

nm

ent

en

han

ce

th

e c

om

pe

titive

ne

ss o

f A

rgyll

an

d B

ute

. T

his

is

th

e p

rog

ress

we e

xp

ec

t to

mak

e in

3 y

ea

rs

Pro

gra

mm

e o

f A

83

im

pro

ve

me

nts

com

ple

ted b

y T

ran

sp

ort

Sco

tla

nd.

A82

im

pro

ve

men

ts a

t P

ulp

it R

ock &

Cria

nla

rich

co

mp

lete

d

an

d fu

rthe

r im

pro

vem

en

ts b

etw

ee

n T

arb

et

and

Cria

nla

rich

id

en

tified

with

in a

fu

nde

d p

rogra

mm

e.

C

oun

cil

pro

gre

sse

s its

po

licy

ob

jective

of

on

go

ing im

pro

ve

me

nt

to r

oa

d c

ond

itio

n th

rou

gh

its

co

mm

itm

en

t to

its

Ro

ad

s A

sse

t M

ana

ge

men

t &

Ma

inte

na

nce

S

tra

tegy.

Esta

blis

hm

en

t of

a h

igh

qu

alit

y a

nd r

elia

ble

to

wn

ce

ntr

e to t

ow

n c

en

tre

ve

hic

ula

r fe

rry s

erv

ice

be

twe

en

Du

no

on

&

Go

uro

ck a

nd u

pgra

de

of

sup

po

rtin

g s

ho

re s

ide

and

pu

blic

tra

nsp

ort

atio

n infr

astr

uctu

re a

nd

se

rvic

es.

Tim

eta

ble

for

the

C

am

pb

elto

wn

-Ard

rossa

n fe

rry s

erv

ice

fin

alis

ed

. F

utu

re o

f th

e C

ou

ncil’

s f

err

y s

erv

ice

s d

ete

rmin

ed

. F

utu

re o

f th

e K

err

era

fe

rry

se

rvic

e d

ete

rmin

ed

. Im

pro

ve

d r

ail

co

nne

ctivity b

etw

ee

n O

ban

, B

ute

& C

ow

al a

nd

He

len

sburg

h a

nd

Lo

mo

nd

w

ith

Gla

sgo

w a

nd

E

din

bu

rgh

with

th

e s

ix G

lasgo

w-O

ba

n s

erv

ice

s c

on

tinu

ed w

ith

sle

epe

r co

nne

ctivity.

In

tro

du

ctio

n o

f n

ew

Pa

rk a

nd R

ide

o

ppo

rtu

nitie

s in

He

len

sb

urg

h a

nd

Du

no

on;

part

icu

larly t

ho

se

pro

vid

ing c

om

mu

ter

links to

Gla

sgo

w.

Ove

r 8

0%

of

the

Arg

yll

an

d B

ute

co

mm

un

itie

s w

ith

in t

he N

ext

Ge

ne

ratio

n B

road

ban

d a

rea

will

ha

ve

acce

ss t

o th

e im

pro

ve

d s

erv

ice

, a

s w

ill 1

00

% in

the

He

len

sb

urg

h

are

a th

rou

gh

th

e R

est of

Scotla

nd

pro

gra

mm

e.

Imp

rove

d c

on

ne

ctivity b

etw

ee

n A

rgyll

& B

ute

’s isla

nd a

nd

ma

inla

nd

airp

ort

s w

ith

G

lasgo

w A

irp

ort

an

d w

ith

the

Weste

rn I

sle

s. C

om

ple

tio

n o

f th

e c

on

str

uctio

n o

f th

e C

arr

ad

ale

-Hu

nte

rsto

n u

nde

rse

a g

rid

lin

k.

D

eliv

ery

of

the

Str

ate

gic

Ho

usin

g I

nve

stm

en

t P

lan

20

13

-18

Th

is i

s w

he

re w

e a

re n

ow

T

he

re is a

pe

rcep

tion

th

at

the

infr

astr

uctu

re in A

rgyll

an

d B

ute

is a

ba

rrie

r to

gro

wth

. T

his

is e

vid

en

ce

d b

y u

nde

r in

ve

stm

en

t in

in

fra

str

uctu

re o

ve

r a

nu

mbe

r of

ye

ars

by b

oth

priva

te a

nd p

ub

lic s

ecto

rs a

nd p

oo

r m

ob

ile p

ho

ne

an

d b

roa

dba

nd s

erv

ice

s,

lack o

f e

lectr

icity g

rid

ca

pa

city a

nd s

tan

da

rd o

f str

ate

gic

ro

ad

s. W

hils

t th

ere

is a

cle

ar

ne

ed

to in

ve

st

in im

pro

ve

men

ts to

infr

astr

uctu

re

Page 38 7.3i - Appendix 1

Page 85: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

���

�mu

ch o

f th

e c

ore

asse

t b

ase is s

oun

d. C

PP

pa

rtn

ers

ha

ve

de

ve

lop

ed

str

en

gth

en

ing w

ork

ing r

ela

tio

nsh

ips w

ith

the k

ey p

ub

lic a

nd

p

riva

te s

ecto

r sta

ke

ho

lde

rs a

nd

ha

ve

app

roa

ch

ed

th

e r

equ

ire

men

t to

de

ve

lop

a m

ore

str

ate

gic

an

d in

tegra

ted

ap

pro

ach

to

wa

rds

po

licy d

eve

lop

men

t th

rou

gh

AB

RA

, H

ITR

AN

s a

nd t

hro

ugh

dire

ct p

art

ne

rsh

ip w

ork

ing w

ith

Tra

nsp

ort

Sco

tlan

d.

Th

es

e a

re t

he

ke

y s

tra

teg

ies a

nd

de

live

ry p

lan

s

Acro

ss t

he

CP

P e

ach p

art

ne

r h

as s

tra

tegie

s a

nd

pla

ns w

hic

h w

ill c

on

trib

ute

to

th

e d

eve

lopm

ent

of

infr

astr

uctu

re p

rovis

ion

with

in

Arg

yll

& B

ute

. T

he

de

ve

lopm

ent

an

d r

eso

urc

ing o

f th

e p

rop

ose

d S

tra

tegic

Infr

astr

uctu

re P

lan

, d

eve

lop

ed

in

pa

rtne

rsh

ip w

ith

th

e

Sco

ttis

h G

ove

rnm

en

t, w

ill p

rovid

e t

he

me

chan

ism

to

ach

ieve

th

e r

equ

ire

d im

pro

ve

me

nt to

in

fra

str

uctu

re a

nd

ho

usin

g n

ee

de

d to

su

ppo

rt t

he

de

live

ry o

f th

e S

OA

ou

tco

me

s o

f e

co

no

mic

an

d p

op

ula

tio

n g

row

th.

Oth

er

pla

ns a

nd s

tra

tegie

s in

clu

de -

Lo

ca

l D

eve

lop

men

t P

lan

, E

co

nom

ic D

eve

lopm

ent P

lan

, R

en

ew

ab

le E

ne

rgy A

ctio

n P

lan

, R

oa

ds A

sse

t M

an

age

me

nt a

nd

Ma

inte

nan

ce

S

tra

tegy,

Sco

ttis

h F

err

ies P

lan,

Str

ate

gic

Ho

usin

g I

nve

stm

ent

Pla

n 2

01

3-1

8,

CH

OR

D p

rogra

mm

e, H

IE O

pe

ratin

g P

lan

an

d p

lan

s

for

roll

ou

t of

bro

ad

band

. T

he

se

are

so

me

of

the

ma

in a

rea

s o

f fo

cu

s i

nc

lud

ed

wit

hin

th

is o

utc

om

e

Th

is o

utc

om

e in

clu

de

s th

e fo

llow

ing in

fra

str

uctu

re,

ho

usin

g,

com

mun

ity f

acili

tie

s to

sup

po

rt h

ou

sin

g,

road

tra

nsp

ort

, o

the

r m

od

es o

f tr

an

sp

ort

(a

ir, fe

rrie

s,

rail,

pie

rs a

nd

ha

rbou

rs),

utilit

ies (

ele

ctr

icity g

rid

and

wa

ter

and

se

we

rage

ne

two

rk)

an

d IT

/IC

T (

mo

bile

pho

ne

an

d b

road

ban

d).

Page 39 7.3i - Appendix 1

Page 86: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

��

�Lo

ng

Te

rm O

utc

om

e -

In

Arg

yll

an

d B

ute

ed

uc

ati

on

, sk

ills

an

d t

rain

ing

max

imis

es o

pp

ort

un

itie

s f

or

all

. W

ha

t s

ucc

es

s w

ill

be l

ike i

n 1

0 y

ea

rs

All

of

ou

r yo

un

g p

eop

le h

ave

the

op

po

rtu

nity t

o a

ch

ieve

a p

ositiv

e a

nd

su

sta

ine

d d

estin

atio

n.

Lo

ca

l la

bou

r m

ark

et

info

rma

tion

sh

ape

s h

ow

hig

he

r e

du

ca

tion

and

fu

rth

er

edu

ca

tion

cu

rric

ulu

m a

nd t

rain

ing a

re b

ein

g d

eve

lop

ed

. E

ve

ryo

ne

ha

s a

cce

ss to

tra

inin

g

an

d s

kill

s d

eve

lop

me

nt o

ppo

rtu

nitie

s o

f th

eir c

ho

ice

. A

lign

ing e

du

ca

tio

n,

skill

an

d t

rain

ing p

rovis

ion

with

la

bou

r m

ark

et

ne

ed

s w

ill

ma

xim

ise

op

po

rtu

nity fo

r o

ur

pe

op

le b

ut

als

o e

nsu

re a

sup

ply

of

ed

uca

ted,

skill

ed

an

d tra

ine

d p

eo

ple

to s

upp

ort

the

lo

ca

l e

co

no

my.

Th

is i

s t

he p

rog

ress

we e

xp

ec

t to

mak

e in

3 y

ea

rs

Fu

rth

er

pro

gre

ss in

re

latio

n to

th

e r

ed

uctio

n in

the

nu

mb

er

of

yo

un

g p

eop

le lea

vin

g s

ch

oo

l w

ith

ou

t a

po

sitiv

e a

nd

su

sta

ine

d

de

stina

tio

n. S

cho

ols

ha

ve

un

de

rta

ken

fu

rth

er

cu

rric

ulu

m r

efo

rm to

su

ppo

rt t

he

ne

w n

atio

nal qu

alif

ica

tion

s a

nd

to

en

su

re y

ou

ng

pe

op

le h

ave

th

e o

pp

ort

un

ity t

o f

ollo

w a

pro

gra

mm

e ta

ilore

d to

th

eir n

ee

ds. In

cre

ase

d o

pp

ort

un

itie

s fo

r a

lte

rna

tive

qu

alif

ica

tio

ns.

Clo

se

r lin

ks t

o lo

ca

l la

bo

ur

ma

rke

t a

na

lysis

and

the

op

tio

ns o

ffe

red

by s

ch

oo

ls a

nd H

igh

er

an

d F

urt

he

r E

du

ca

tio

n p

rovid

ers

. In

cre

ased

op

po

rtu

nitie

s f

or

me

an

ingfu

l sh

ort

an

d lo

ng t

erm

em

plo

ym

ent

exp

erie

nce

. T

he

co

rpo

rate

pa

ren

tin

g s

up

po

rt b

y C

PP

p

art

ne

rs fo

r Lo

oked

Afte

r C

hild

ren

is im

pro

ve

d a

nd

is n

arr

ow

ing t

he

in

equ

alit

y g

ap

fo

r th

em

. O

ngo

ing r

evie

w o

f sco

pe

of

skill

s a

nd

tr

ain

ing d

eve

lopm

ent

to r

efle

ct d

em

an

d a

nd ta

ke

op

po

rtu

nitie

s t

o incre

ase

scop

e a

nd

ra

nge

of

this

pro

vis

ion

. T

his

is

wh

ere

we

are

no

w

The

ed

ucatio

na

l a

tta

inm

ent

in A

rgyll

an

d B

ute

is a

bo

ve

th

e n

atio

na

l a

ve

rage

in

mo

st m

ea

su

res.

Sch

oo

ls in

cre

asin

gly

off

er

acce

ss t

o

a r

an

ge

of

wid

er

qu

alif

ica

tio

ns to

assis

t p

up

ils w

ith

vo

ca

tio

na

l ro

ute

s p

rovid

ing a

cce

ss t

o F

E/H

E c

ou

rse

s in

scho

ols

. T

he

re a

re

incre

asin

g t

ren

ds in

the

num

be

r of

adu

lts w

ho

are

acce

ssin

g a

ctivitie

s s

upp

ort

ing t

he

ir lite

racy a

nd

nu

me

racy.

Inde

pen

den

t, th

ird

a

nd

pu

blic

se

cto

r p

rovid

ers

off

er

a r

an

ge

of

skill

s a

nd

tra

inin

g d

eve

lop

me

nt.

Th

es

e a

re t

he

ke

y s

tra

teg

ies a

nd

de

live

ry p

lan

s

Ed

ucatio

n A

ctio

n P

lan

, C

urr

icu

lum

fo

r E

xce

llen

ce

Im

ple

men

tatio

n P

lan

, In

div

idu

al scho

ol im

pro

ve

me

nt p

lan

s,

Opp

ort

un

itie

s f

or

All

De

ve

lop

men

t P

lan

, A

rgyll

an

d B

ute

Skill

s P

ipe

line

, A

rgyll

an

d B

ute

Yo

uth

Em

plo

ym

en

t A

ctivity P

lan

, T

hird

Se

cto

r P

art

ne

rsh

ip

Bu

sin

ess P

lan

, A

rgyll

Vo

lun

tary

Actio

n S

tra

tegic

Pla

n

Th

es

e a

re s

om

e o

f th

e m

ain

are

as

of

foc

us i

nc

lud

ed

wit

hin

th

is o

utc

om

e

Yo

un

g p

eop

le w

ith

a p

ositiv

e a

nd

su

sta

ine

d d

estin

atio

n. A

lign

me

nt

of

FE

/ H

E c

ou

rse

pro

vis

ion

with

lo

ca

l la

bo

ur

mark

et

ana

lysis

. M

ore

adu

lts w

ith

lite

racy,

nu

me

racy,

or

ba

sic

IC

T issu

es a

re s

up

po

rte

d to

acce

ss a

nd

pro

gre

ss in

"firs

t ste

ps"

lea

rnin

g

op

po

rtu

nitie

s.

Prim

ary

, se

co

nd

ary

an

d te

rtia

ry e

du

ca

tio

n a

nd

tra

inin

g/s

kill

s d

eve

lop

me

nt.

Page 40 7.3i - Appendix 1

Page 87: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

��

�Lo

ng

Te

rm O

utc

om

e -

In

Arg

yll

an

d B

ute

ch

ild

ren

an

d y

ou

ng

pe

op

le h

ave

th

e b

es

t p

os

sib

le s

tart

Wh

at

su

cc

es

s w

ill

be l

ike i

n 1

0 y

ea

rs

All

ou

r ch

ildre

n w

ill b

e m

ore

active

an

d h

ave

in

cre

ased

op

po

rtu

nitie

s t

o p

art

icip

ate

in

pla

y,

recre

ation

an

d s

po

rt. T

he

re w

ill b

e a

n

incre

ase

in im

pro

ve

men

t in

ch

ildre

n’s

he

alth a

nd

we

llbe

ing.

Re

du

ced

num

be

rs o

f lo

oked

afte

r ch

ildre

n w

ill b

e a

ble

to

rem

ain

in

th

eir lo

ca

l co

mm

un

ity a

s a

re

su

lt o

f fle

xib

le s

up

po

rt p

acka

ge

s. In

tegra

ted d

eliv

ery

of

pu

blic

pro

tection

sup

po

rts v

uln

era

ble

ch

ildre

n

an

d y

ou

ng p

eop

le.

Con

tin

ue

d d

eve

lop

me

nt of

hig

h q

ua

lity le

arn

ing o

ppo

rtu

nitie

s

Th

is i

s t

he p

rog

ress

we e

xp

ec

t to

mak

e in

3 y

ea

rs

Lite

racy le

ve

ls o

f ch

ildre

n c

on

tin

ue

to

im

pro

ve

. T

he

re a

re in

cre

ase

d le

ve

ls o

f p

art

icip

atio

n f

or

ch

ildre

n a

nd

yo

un

g p

eo

ple

in

ph

ysic

al

activity.

Th

e t

reatm

en

t ga

ps in

se

rvic

es f

or

ch

ildre

n a

nd

yo

un

g p

eo

ple

ha

ve

be

en a

dd

ressed

with

ap

pro

pria

te s

erv

ice

s.

Atta

inm

ent

of

loo

ke

d a

fte

r ch

ildre

n is im

pro

vin

g a

nd

le

ve

ls o

f e

xclu

sio

n r

ed

ucin

g.

Go

od

qu

alit

y s

up

po

rt is a

va

ilab

le t

o a

llow

ch

ildre

n t

o r

em

ain

w

ith

in t

he

ir o

wn

co

mm

un

itie

s. Im

pro

ve

d q

ua

lity &

co

nsis

ten

cy t

o e

nsu

re a

ll ch

ildre

n a

re p

rote

cte

d f

rom

ab

use

, n

egle

ct

an

d h

arm

. C

o-p

rod

uction

is e

mbed

ded

acro

ss A

rgyll

an

d B

ute

. T

his

is

wh

ere

we

are

no

w

Arg

yll

an

d B

ute

ha

s a

co

mp

reh

en

siv

e e

arly y

ea

rs s

erv

ice

off

erin

g g

oo

d q

ua

lity s

upp

ort

to

wo

me

n t

hro

ugh

the

ir p

regn

an

cy a

nd

b

eyo

nd

. Q

ua

lity o

f a

sse

ssm

en

t is

im

pro

vin

g h

ow

eve

r qu

alit

y o

f ca

re p

lan

nin

g a

nd

ris

k a

ssessm

ent

ne

ed

s f

urt

he

r su

ppo

rt.

W

e a

re d

eve

lop

ing c

opro

du

ction

of

all

leve

ls w

ith

ch

ildre

n a

nd

yo

ung p

eo

ple

in

com

mu

nitie

s t

o info

rm h

ow

we

bu

ild c

apa

city a

nd

sta

bili

ty

Th

es

e a

re t

he

ke

y s

tra

teg

ies a

nd

de

live

ry p

lan

s

The

Inte

gra

ted

Ch

ildre

n’s

Se

rvic

e P

lan

will

be

th

e m

ain

do

cum

ent

tha

t w

ill b

e u

se

d a

cro

ss a

ll p

art

ne

rs o

ve

r th

e n

ext

thre

e y

ea

rs t

o

drive

pe

rfo

rman

ce

aga

inst

ke

y o

utc

om

es.

Th

es

e a

re s

om

e o

f th

e m

ain

are

as

of

foc

us i

nc

lud

ed

wit

hin

th

is o

utc

om

e

Th

is in

clu

de

s e

nsu

rin

g c

hild

ren

an

d y

ou

ng p

eo

ple

are

pro

tecte

d f

rom

ab

use,

ne

gle

ct

and

ha

rm, a

re m

ore

active

an

d h

ave

mo

re

op

po

rtu

nitie

s t

o p

art

icip

ate

in

pla

y, r

ecre

ation a

nd s

po

rt, liv

e w

ith

in a

fam

ily s

up

po

rtiv

e e

nvir

on

me

nt, h

ave

th

e h

igh

est

po

ssib

le

sta

nda

rds o

f ph

ysic

al a

nd

me

nta

l he

alth

, can

acce

ss to

po

sitiv

e le

arn

ing e

nviro

nm

en

ts a

nd o

ppo

rtu

nitie

s t

o d

eve

lop

skill

s a

nd

ha

ve

th

eir v

oic

es h

ea

rd a

nd

are

en

co

ura

ge

d t

o p

lay a

n a

ctive

an

d r

esp

on

sib

le r

ole

in

co

mm

un

itie

s.

Co

llab

ora

tive

wo

rkin

g t

o d

eliv

er

qu

alit

y s

erv

ice

s e

arly in

life

off

ers

rea

l a

nd

tan

gib

le o

utc

om

es fo

r child

ren

, yo

un

g p

eo

ple

an

d th

eir f

am

ilie

s. T

his

in

clu

de

s p

rom

otin

g

pre

ve

ntio

n a

nd t

acklin

g p

ove

rty,

ine

qu

alit

y a

nd

po

or

ou

tcom

es b

y e

mp

ow

erin

g c

om

mun

itie

s t

o w

ork

to

ge

the

r.

Page 41 7.3i - Appendix 1

Page 88: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

���

�Lo

ng

Te

rm O

utc

om

e –

Pe

op

le l

ive

ac

tive

, h

ea

lth

ier

an

d i

nd

ep

en

de

nt

live

s.

Wh

at

su

cc

es

s w

ill

be l

ike i

n 1

0 y

ea

rs

Pe

op

le a

re a

ctive

and

he

alth

ier

acro

ss a

ll d

ime

nsio

ns o

f h

ea

lth

an

d w

ellb

ein

g.

Th

ose

wh

o a

re o

lde

r, liv

ing w

ith

lo

ng t

erm

co

nd

itio

ns

or

vu

lne

rab

le a

re in

cre

asin

gly

be

ing s

up

po

rted

to

ma

inta

in t

he

ir in

dep

end

en

ce

fo

r a

s lon

g a

s t

he

y c

hoo

se

. L

ife

exp

ecta

ncy is s

till

ab

ove

the

Sco

ttis

h a

ve

rage

with

in

cre

asin

g h

ea

lth

y life

exp

ecta

ncy.

The

he

alth o

utc

om

es fo

r th

ose

liv

ing in

ou

r m

ost

de

prive

d

co

mm

un

itie

s a

re c

loser

to t

ho

se

of

ou

r m

ost aff

luen

t a

rea

s.

Co

mm

un

itie

s a

re a

ctive

in

co

-pro

du

cin

g t

he

se

rvic

es t

he

y h

ave

a

sp

ira

tio

ns f

or.

Pe

op

le le

ad

mo

re a

ctive

hea

lth

ier

live

s t

hro

ugh

in

cre

ase

d p

art

icip

atio

n in s

po

rt a

nd

ph

ysic

al a

ctivity.

Th

is i

s t

he p

rog

ress

we e

xp

ec

t to

mak

e in

3 y

ea

rs

Co

ntin

uin

g to

be

ab

ove

the

Scott

ish

ave

rage

in

te

rms o

f lif

e e

xp

ecta

ncy a

nd

he

alth

y life

exp

ecta

ncy w

ith

wo

rk in

pla

ce

to

re

du

ce

h

ea

lth

in

equ

alit

ies a

nd

ta

rge

t a

ctivity t

o t

ho

se

mo

st

in n

ee

d.

Old

er

peo

ple

rep

ort

ing t

ha

t th

ey f

ee

l su

ppo

rte

d t

o liv

e in

dep

end

ently

wh

ere

th

ey c

ho

ose

. M

ore

peo

ple

with

he

alth a

nd

ca

re n

eed

s liv

e a

t h

om

e o

r in

a h

om

ely

se

ttin

g.

Fe

we

r e

me

rge

ncy a

dm

issio

ns o

f o

lde

r pe

op

le.

Th

is i

s w

he

re w

e a

re n

ow

A

rgyll

an

d B

ute

is a

bo

ve

the

Scott

ish

ave

rage

in

te

rms o

f lif

e e

xp

ecta

ncy.

Ou

r h

ea

lth

y life

exp

ecta

ncy is 6

8.5

ye

ars

(m

ale

s)

an

d

72

.5 y

ea

rs (

fem

ale

s)

co

mpa

red t

o th

e S

co

ttis

h a

ve

rage

of

66

.3 (

ma

les)

an

d 7

0.2

(fe

ma

les).

With

in t

he

are

a h

ow

eve

r w

e h

ave

h

ea

lth

in

equ

alit

ies. T

he

se

are

ma

nife

st

thro

ugh

ou

t ou

r ru

ral com

mun

itie

s a

nd

are

no

t ea

sily

me

asu

red.

Ho

we

ve

r w

e s

ee

th

e e

ffe

ct

of

the

se

in

equ

alit

ies in o

ur

tow

ns. T

he

re a

re 1

0 a

rea

s in

to

tal, w

ith

in C

am

pb

elto

wn

, D

uno

on,

He

len

sb

urg

h,

Oba

n a

nd

Ro

the

sa

y,

inclu

de

d in

th

e 1

5%

mo

st

de

prive

d s

ma

ll a

rea

s in

Sco

tla

nd

. M

ost o

lde

r p

eo

ple

(6

5+

) in

Arg

yll

an

d B

ute

loo

k a

fte

r th

em

se

lve

s a

t h

om

e,

with

va

ryin

g d

egre

es o

f he

lp. 3

% a

re c

are

d fo

r in

th

e ‘fo

rma

l’ se

ttin

g o

f a

ca

re h

om

e o

r sim

ilar.

T

he

se

are

th

e k

ey s

tra

teg

ies a

nd

de

live

ry p

lan

s

The

re a

re m

an

y p

lan

s a

cro

ss t

he

CP

P a

nd

with

in ind

ivid

ua

l p

art

ne

rs.

T

he

se

are

so

me

of

the

ma

in a

rea

s o

f fo

cu

s i

nc

lud

ed

wit

hin

th

is o

utc

om

e

Eve

ryo

ne

ha

s t

he

op

po

rtu

nity t

o b

e a

ctive

me

mbe

rs o

f th

eir c

om

mun

ity.

Pe

op

le a

re e

nab

led

to

liv

e in

dep

en

den

tly,

with

me

an

ing

an

d p

urp

ose

, w

ith

in the

ir o

wn

co

mm

un

ity.

Peo

ple

are

em

po

we

red

to le

ad

th

e h

ea

lth

iest liv

es p

ossib

le.

He

alth

ier

ch

oic

es r

ega

rdin

g

alc

oh

ol a

nd d

rugs a

nd

re

co

ve

ry f

rom

sub

sta

nce

mis

use

. M

en

tal h

ea

lth

im

pro

ve

men

t str

ate

gie

s a

re p

rom

ote

d b

y t

he

CP

P. T

he

ga

p

be

twe

en

th

e b

est of

and

the

wo

rst

off

in

Arg

yll

an

d B

ute

is r

ed

uced

.

Page 42 7.3i - Appendix 1

Page 89: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

���

�Lo

ng

Te

rm O

utc

om

e –

Pe

op

le l

ive

in

sa

fer

an

d s

tro

ng

er

co

mm

un

itie

s

Wh

at

su

cc

es

s w

ill

be l

ike i

n 1

0 y

ea

rs

We h

ave

safe

an

d s

tron

g c

om

mu

nitie

s w

he

re o

ur

pe

op

le liv

e f

ree

fro

m h

arm

, fe

ar

and

ad

vers

ity in

an

equ

al so

cie

ty.

Th

ere

are

th

rivin

g a

nd

su

sta

ina

ble

com

mu

nitie

s p

art

icip

atin

g in

and

con

trib

uting t

o t

he s

ocia

l a

nd

fis

ca

l h

ea

lth

of

Arg

yll

& B

ute

. O

ur

pe

op

le

are

co

nfid

en

t in

th

e s

erv

ice

s w

hic

h s

up

po

rt q

ua

lity o

f lif

e t

hro

ugh

the

ir o

wn

de

sig

n a

nd d

eliv

ery

of

the

se s

erv

ice

s.

Ou

r to

wn

ce

ntr

es

are

th

rivin

g a

nd

vib

ran

t. R

ege

ne

ratio

n o

f th

e b

uilt

en

viro

nm

en

t e

nha

nce

s t

he

com

pe

titive

ne

ss o

f A

rgyll

an

d B

ute

.

Th

is i

s t

he p

rog

ress

we e

xp

ec

t to

mak

e in

3 y

ea

rs

A s

tre

ngth

en

ed

com

mu

nity s

afe

ty p

art

ne

rsh

ip s

tru

ctu

re t

o e

nsu

re a

ll co

mm

un

itie

s a

re d

yn

am

ic a

nd

su

sta

ina

ble

. E

vid

en

ce

of

safe

r,

mo

re r

ob

ust a

nd

he

alth

y c

om

mu

nitie

s a

nd

red

ucin

g le

ve

ls o

f in

equalit

ies.

Co

mm

un

ity e

nga

ge

me

nt is

enh

an

ce

d a

nd

pe

op

le c

ho

ose

to e

nga

ge

with

th

e d

esig

n a

nd

de

live

ry o

f p

ublic

se

rvic

es a

nd

und

ers

tan

d s

afe

ty is e

ve

ryo

ne

’s b

usin

ess.

Ea

rly in

terv

en

tio

n a

nd

p

reve

ntio

n is b

egin

nin

g t

o d

eliv

er

be

tte

r o

utc

om

es.

Cle

ar

pla

ns fo

r d

eve

lop

me

nt of

tow

n c

en

tre

s a

nd b

uilt

en

viro

nm

en

t w

ith

in

ve

stm

en

t u

nd

erw

ay.

Th

is i

s w

he

re w

e a

re n

ow

T

he

com

mu

nitie

s in

Arg

yll

in B

ute

are

safe

pla

ce

s to

liv

e,.

Th

ey a

re s

tro

ng a

nd v

ibra

nt

in m

an

y a

rea

bu

t w

e a

lso

ha

ve

so

me a

rea

s

wh

ere

pe

op

le a

re le

ss e

nga

ge

d w

he

re a

cce

ss a

nd s

ocia

l de

priva

tio

n c

ha

llen

ge

qu

alit

y o

f lif

e. W

e h

ave

a g

ood

reco

rd in

ma

inta

inin

g

pu

blic

safe

ty a

nd r

ecogn

ise

th

at to

im

pro

ve

th

is w

e m

ust e

nha

nce

ou

r p

art

ne

rsh

ips a

nd m

ake

str

on

ge

r lo

ca

l lin

ks w

hic

h c

on

trib

ute

to

com

mu

nity life

. W

e h

ave

a p

rove

n r

eco

rd o

f vo

lun

tary

actio

n a

nd c

om

mun

itie

s w

ork

ing a

nd

we

ha

ve

to

bu

ild o

n c

urr

en

t ca

pa

city

an

d s

et fo

un

da

tio

ns fo

r gre

ate

r su

sta

ina

bili

ty a

nd

th

rivin

g c

om

mun

ity life

. T

he

se

are

th

e k

ey s

tra

teg

ies a

nd

de

live

ry p

lan

s

The

Com

mu

nity P

lann

ing p

art

ne

rsh

ip s

up

po

rte

d b

y lo

ca

l P

olic

e p

lan

, F

ire

pla

n, T

hird

Se

cto

r P

art

ne

rsh

ip B

usin

ess P

lan

an

d

Co

mm

un

ity E

nga

ge

men

t S

trate

gy c

urr

en

tly a

ll d

rive

th

is o

utc

om

e. T

he

lo

ca

l a

rea

Gro

up

s, C

om

mun

ity s

afe

ty p

art

ne

rsh

ips a

nd

d

evo

lve

d A

SB

gro

up

s a

ga

in t

actica

lly d

rive

th

e o

utc

om

e,

wh

ere

it

is e

sse

ntia

l th

at

we

lo

ok c

lose

r a

t th

e d

eliv

ery

an

d o

ur

ab

ility

to

T

ask a

nd

Co

ord

ina

te th

rou

gh

ou

r m

ulti-a

ge

ncy p

art

ne

rsh

ips. O

utc

om

e fo

cu

sse

d c

om

mun

ity s

afe

ty p

lan

s d

eve

lope

d.

Th

es

e a

re s

om

e o

f th

e m

ain

are

as

of

foc

us i

nc

lud

ed

wit

hin

th

is o

utc

om

e

En

su

rin

g c

om

mu

nitie

s fe

el safe

r an

d th

at A

rgyll

an

d B

ute

is a

safe

r p

lace

. S

upp

ort

ing c

om

mu

nitie

s t

o b

eco

me

str

on

g,

resili

en

t a

nd

se

lf-r

elia

nt.

E

nsu

rin

g th

e n

atu

ral a

nd

bu

ilt e

nvir

on

men

t is

safe

, re

spe

cte

d,

va

lue

d a

nd f

ree o

f en

viro

nm

en

tal crim

e. W

ork

ing in

p

art

ne

rsh

ip t

o d

eliv

er

ou

tcom

es e

ffe

ctive

ly a

nd

eff

icie

ntly e

nsu

rin

g b

est

va

lue

.

Page 43 7.3i - Appendix 1

Page 90: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

���

�EQ

UA

LIT

IES

Arg

yll

& B

ute

Com

mu

nity P

lan

nin

g P

art

ne

rsh

ip p

lace

s e

qu

alit

y,

div

ers

ity a

nd

in

clu

siv

en

ess a

t th

e c

en

tre

of

all

its s

erv

ice

s a

nd

a

ctio

ns.

De

live

rin

g a

ga

inst

this

we

co

mm

it to

red

ucin

g in

equ

alit

ies in

all

form

s.

In

add

itio

n t

o th

ose id

en

tifie

d in

th

e E

qu

alit

y A

ct

20

10

, ou

r co

mm

un

itie

s in

Arg

yll

an

d B

ute

fa

ce

th

ree

key a

rea

s o

f po

ten

tia

l in

equ

alit

y t

ha

t w

e m

ust e

nsu

re a

re p

lann

ed f

or

in t

he

SO

A. T

he

se

a

re: •

Ge

ogra

ph

ica

l In

equ

alit

ies –

rem

ote

ne

ss a

nd

pe

rip

he

ralit

y c

an

re

su

lt in

acce

ss a

nd

am

en

ity issu

es

He

alth

ine

qu

alit

ies

Eco

nom

ic ine

qu

alit

ies

To a

dd

ress th

ese

ma

ny a

nd

ch

alle

ngin

g issu

es w

ill r

equ

ire

an

ap

pro

ach

wh

ich

refle

cts

the p

rin

cip

les o

f co

-pro

ductio

n a

nd

wh

ich

e

mb

race

s c

ha

nge

s to

eco

no

mic

, cu

ltu

ral a

nd e

nviro

nm

en

tal co

nd

itio

ns a

nd

pre

va

ilin

g c

ircu

msta

nce

s,

imp

rovin

g infr

astr

uctu

re t

o a

id

an

d o

ve

rco

me

issu

es w

ith

acce

ss t

o s

erv

ice

s;

and

to s

tre

ngth

en

ing c

om

mun

itie

s a

nd

ind

ivid

ua

ls.

Ad

dre

ssin

g t

he

se

will

re

qu

ire

th

e C

PP

pa

rtn

ers

to

co

llate

evid

en

ce

an

d ide

ntify

wh

ere

th

e a

gre

ed

prio

rity

actio

n a

rea

s a

re. T

his

will

b

e a

lign

ed w

ith

th

e s

tra

tegic

ou

tco

me

s in

th

e S

OA

, id

entify

ing c

lea

r a

ctio

ns fo

r de

live

ry.

Ge

ogra

ph

ica

l in

equ

alit

ies a

nd

a c

lea

r an

aly

sis

of

pla

ce

will

be

fu

rthe

r h

igh

ligh

ted

in

th

e a

dd

itio

na

l ce

nsu

s info

rma

tio

n a

t lo

ca

l a

rea

s

wh

ich

will

be

pu

blis

hed t

hro

ugh

ou

t 2

013

. T

his

an

aly

sis

will

in

form

the

str

ate

gic

ap

pro

ach

to o

ur

com

mu

nitie

s a

nd

su

ppo

rt t

he

d

eve

lop

me

nt of

loca

lise

d p

lan

nin

g w

he

re t

his

is a

prio

rity

.

Eco

nom

ic ine

qu

alit

ies, u

nem

plo

ym

en

t a

nd u

nd

er

em

plo

ym

en

t a

re k

ey d

rive

rs f

or

he

alth a

nd g

eo

gra

ph

ica

l in

equ

alit

ies.

Lo

w in

co

me

is w

ide

ly r

eco

gn

ise

d a

s a

drive

r fo

r m

an

y o

the

r a

rea

s o

f in

equ

alit

y.

The

fo

cu

s o

f th

e S

OA

on

eco

nom

ic a

ctivity a

nd

gro

wth

is

fun

da

me

nta

l to

add

ressin

g t

his

.

The

Arg

yll

an

d B

ute

Co

mm

un

ity P

lan

nin

g P

art

ne

rsh

ip:

Un

de

rsta

nd

s its

le

ga

l an

d e

thic

al e

qua

litie

s r

esp

on

sib

ilitie

s to

se

rvic

e u

se

rs,

sta

ff a

nd c

om

mu

nitie

s

Bu

ilds its

ap

pro

ach

to

equ

alit

ies o

n h

um

an

rig

hts

prin

cip

les

Ta

ke

s a

ctio

n to

en

su

re s

erv

ice

s b

eco

me

in

clu

siv

e a

nd

acce

ssib

le to

all

Page 44 7.3i - Appendix 1

Page 91: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

���

Use

s E

qu

alit

y I

mp

act A

sse

ssm

en

t, E

qu

al P

ay A

ud

it a

nd

sim

ilar

ap

pro

ach

es to

ide

ntify

in

equ

alit

ies a

nd w

ays o

f ad

dre

ssin

g

them

Pro

vid

es e

qu

alit

ies t

rain

ing,

de

ve

lopm

ent

an

d s

up

po

rt t

o its

Ma

na

ge

me

nt

Bo

ard

, sta

ff a

nd

pa

rtn

ers

pro

vid

es le

ade

rsh

ip o

n e

qu

alit

ies a

nd

hum

an r

igh

ts

Co

llects

mo

nito

rin

g info

rma

tio

n e

ffe

ctive

ly,

se

nsitiv

ely

an

d in

lin

e w

ith

data

pro

tectio

n la

w to

asse

ss le

ve

ls o

f in

equ

alit

y a

nd

a

rea

s o

f con

ce

rn

Th

rou

gh

its

pa

rtn

ers

en

ga

ge

s w

ith

sta

ff,

se

rvic

e u

se

rs a

nd o

the

r sta

ke

ho

lde

rs in

ord

er

to u

nd

ers

tan

d th

eir n

eed

s

Page 45 7.3i - Appendix 1

Page 92: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

���

�PR

EV

EN

TIO

N P

LA

N

The

CP

P is c

om

mitte

d to

ea

rly in

terv

en

tio

n a

nd

pre

ve

ntion

. P

reve

nta

tive

sp

en

d is d

efine

d a

s “

Actio

ns w

hic

h p

reven

t p

rob

lem

s a

nd

e

ase

fu

ture

de

ma

nd o

n s

erv

ice

s b

y in

terv

en

ing e

arly,

the

reb

y d

eliv

erin

g b

ett

er

ou

tco

me

s a

nd

va

lue

fo

r m

one

y”.

Su

ch

an

ap

pro

ach

is

esse

ntia

l if t

he

cha

llen

ge

s f

acin

g A

rgyll

an

d B

ute

are

to b

e a

dd

resse

d s

ucce

ssfu

lly a

nd

in

a s

usta

ina

ble

ma

nner.

The

ra

nge

of

ch

alle

nge

s fa

cin

g A

rgyll

an

d B

ute

is s

ign

ific

ant

and

wid

e r

an

gin

g a

nd a

mu

lti-fa

cete

d a

pp

roach

to

pre

ve

ntio

n is r

equ

ire

d.

Rath

er

tha

n id

entify

a s

pe

cific

ou

tcom

e r

ela

ted

to

pre

ve

ntio

n t

he

CP

P h

as e

mb

ed

de

d p

reve

ntio

n in t

he

Co

mm

un

ity P

lan

an

d S

ingle

O

utc

om

e A

gre

em

en

t. It

is a

ke

y a

spe

ct of

ea

ch

of

the lo

ng t

erm

ou

tco

me

s.

Ine

qu

alit

ies in h

ea

lth

, ed

uca

tio

n a

nd

em

plo

ym

en

t re

ma

in a

ch

alle

nge a

nd s

om

e o

f th

e p

rob

lem

s fa

ced

by o

ur

com

mu

nitie

s h

ave

b

een

re

sis

tan

t to

im

pro

ve

me

nt a

nd h

ave

en

dure

d f

or

de

cad

es. T

he C

om

mu

nity P

lann

ing P

art

ne

rsh

ip is c

om

mitte

d t

o b

rea

kin

g th

at

cycle

th

rou

gh

pre

ve

ntio

n a

nd

ea

rly in

terv

en

tio

n.

Critica

l to

th

is is the

co

ntin

ued

im

pro

ve

me

nts

in in

tegra

tin

g a

nd

sh

arin

g info

rma

tio

n

be

twe

en

pa

rtne

rs,

ana

lysin

g t

ha

t in

form

atio

n a

nd

en

su

rin

g th

at

it is u

se

d to

de

ve

lop

a s

ha

red

ap

pro

ach

to

ach

ieve

ou

r o

utc

om

es.

Str

ate

gic

Pre

ve

nti

on

Pri

ori

tie

s

The

pro

po

sa

ls s

et o

ut

in t

he

Sin

gle

Ou

tcom

e A

gre

em

en

t see

k to

add

ress p

reve

ntion

in

te

rms o

f:

Ad

dre

ssin

g p

op

ula

tio

n d

eclin

e to

pre

ve

nt

the

difficu

ltie

s th

at w

ill a

rise

ba

se

d o

n p

roje

cte

d d

em

ogra

ph

ic c

han

ge

and

p

opu

latio

n r

ed

uctio

n.

En

su

rin

g a

mo

re e

cono

mic

ally

active

Arg

yll

an

d B

ute

th

at

con

trib

ute

s f

ina

ncia

lly

Imp

rovin

g t

he

skill

s a

nd

att

itu

de

s o

f p

eo

ple

to s

usta

in s

ucce

ss w

hic

h w

ill im

pro

ve

re

sili

en

ce a

nd f

lexib

ility

Inve

stin

g in

th

rivin

g a

nd

su

sta

ina

ble

com

mu

nitie

s w

hic

h w

ill h

elp

re

info

rce

the

so

cia

l, c

ivic

an

d c

om

mu

nity b

ack u

p t

o s

up

po

rt

a p

reve

nta

tive

ap

pro

ach

The

com

mitm

en

ts o

n in

equ

alit

ies w

hic

h w

ill s

ee

eff

ort

dire

cte

d t

o im

pro

ve

th

e liv

es o

f th

e m

ost

vu

lne

rab

le

The

spe

cific

outc

om

es a

rou

nd

ch

ildre

n a

nd

peo

ple

liv

ing a

ctive

he

alth

ier

live

s w

hic

h is c

on

sis

ten

t w

ith

the

ob

jective

s o

f p

reve

ntio

n a

nd e

arly in

terv

en

tio

n

Ou

r com

mitm

en

t a

nd

ap

pro

ach

to p

art

ne

rsh

ip w

ork

ing,

wo

rkin

g w

ith

th

ird

se

cto

r a

nd

co

–p

rod

uctio

n w

hic

h w

ill f

urt

he

r em

be

d

ea

rly in

terv

en

tio

n a

nd

pre

ve

ntio

n a

t a

ll le

ve

l in

Arg

yll

an

d B

ute

In lin

e w

ith

the

Sco

ttis

h G

ove

rnm

en

ts S

OA

Gu

ida

nce

the

Com

mu

nity P

lan

nin

g P

art

ne

rsh

ip w

ill:

Ide

ntify

ke

y p

reve

nta

tive

activitie

s a

lre

ad

y in

pla

ce

re

latin

g to

ea

ch

ou

tcom

e

Ide

ntify

be

st

pra

ctice

an

d e

nco

ura

ge

wid

er

rep

lica

tio

n

Page 46 7.3i - Appendix 1

Page 93: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

���

Me

asu

re th

e r

eso

urc

es c

om

mitte

d to

pre

ve

ntio

n a

nd

th

e s

ca

le o

f p

reve

nta

tive

activity;

an

d

En

co

ura

ge

and

sup

po

rt o

pp

ort

un

itie

s to

id

en

tify

ne

w a

pp

roa

che

s,

and

ro

ll o

ut o

r in

cre

ase

exis

tin

g a

ctivity

Re

ce

nt S

co

ttis

h G

ove

rnm

en

t C

ha

nge

Fun

ds h

ave

en

ab

led u

s to

deve

lop

jo

int

pla

nn

ing a

nd

com

mis

sio

nin

g p

rocesse

s a

nd

p

reve

nta

tive

sp

en

din

g in

re

latio

n t

o E

arly Y

ea

rs a

nd

Old

er

Pe

op

le is n

ow

a p

rio

rity

. T

he

re

ce

ntly f

orm

ed

Ea

rly Y

ea

rs C

olla

bo

rative

w

ill id

en

tify

evid

en

ce b

ase

d p

reve

nta

tive

activitie

s t

hat

can

be

re

plic

ate

d a

cro

ss A

rgyll

an

d B

ute

. W

e k

no

w t

ha

t by in

ve

stin

g in

ea

rly

ye

ars

we

ca

n r

edu

ce

th

e p

ote

ntia

l p

rob

lem

s o

f th

e fu

ture

and

cha

llen

ge

th

e lin

k b

etw

ee

n p

ove

rty a

nd

po

or

att

ain

me

nt

an

d

ach

ieve

men

t. S

tra

tegic

pre

ve

ntio

n p

rio

ritie

s w

ill r

esp

on

d t

o th

e c

om

ple

x n

ee

ds o

f a

du

lts a

nd c

hild

ren

exp

erie

ncin

g in

equ

alit

ies. A

vita

l p

art

of

imp

rovin

g t

he

so

cia

l a

nd

eco

nom

ic w

ellb

ein

g o

f p

eop

le in

Arg

yll

an

d B

ute

is t

o b

uild

th

e c

ap

acity w

ith

in in

div

idu

als

an

d

co

mm

un

itie

s.

Em

po

we

rin

g p

eo

ple

to h

elp

the

mse

lve

s u

nd

erp

ins t

he

app

roa

ch

of

the

Com

mu

nity P

lann

ing P

art

ne

rsh

ip.

Th

rou

gh

co

-pro

du

ctio

n w

e w

ill p

rovid

e s

erv

ice

s f

or

pe

op

le,

with

pe

op

le. B

y d

oin

g t

his

we

no

t on

ly b

uild

in

div

idu

al a

nd

com

mu

nity c

ap

acity

bu

t a

lso

en

ab

le p

eo

ple

to

se

cu

re b

ette

r o

utc

om

es fo

r th

em

se

lve

s.

The

ap

pro

ach

to

pe

rfo

rma

nce

ma

na

ge

me

nt w

ill p

rovid

e t

he

evid

en

ce t

o a

llow

us to

asse

ss o

ur

pro

gre

ss in

re

latio

n t

o p

reve

ntio

n

an

d w

he

re it

is n

ece

ssa

ry t

o c

ha

nge

ou

r ap

pro

ach

to

ach

ieve

bett

er

resu

lts.

Page 47 7.3i - Appendix 1

Page 94: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

���

�EN

GA

GE

ME

NT

AN

D E

MP

OW

ER

ME

NT

Arg

yll

an

d B

ute

is a

n a

rea

defin

ed

by d

ive

rsity o

f ge

ogra

ph

y a

nd

of co

mm

un

ity.

En

ga

ge

men

t w

ith

an

d e

mp

ow

erm

en

t of

ou

r co

mm

un

itie

s is e

sse

ntia

l to

en

su

rin

g t

ha

t A

rgyll

an

d B

ute

Co

mm

un

ity P

lan

nin

g P

art

ne

rs d

esig

n,

de

ve

lop

an

d d

eliv

er

the

se

rvic

es

tha

t o

ur

com

mun

itie

s n

ee

d.

The

pa

rtn

ers

hip

is c

urr

en

tly c

on

su

ltin

g o

n a

ne

w C

om

mun

ity E

nga

ge

men

t S

tra

tegy t

ha

t w

ill h

elp

us a

ll to

le

arn

mo

re a

bo

ut

co

mm

un

ity e

nga

ge

men

t an

d im

pro

ve

the

wa

y w

e w

ork

with

diffe

rent

co

mm

un

itie

s.

The

Lo

ca

l G

ove

rnm

en

t in

Sco

tla

nd A

ct 2

003

in

tro

du

ce

d c

om

mu

nity p

lan

nin

g a

nd

mad

e c

om

mu

nity e

nga

ge

me

nt a

sta

tuto

ry

resp

on

sib

ility

of

all

pa

rtn

er

age

ncie

s.

Imp

ort

antly,

it s

hifte

d th

e r

esp

on

sib

ility

fo

r pa

rtic

ipa

tion

, re

qu

irin

g a

ge

ncie

s to

en

ga

ge

with

th

e

co

mm

un

ity r

ath

er

tha

n a

skin

g t

he

co

mm

un

ity t

o e

nga

ge

with

th

em

.

The

Com

mu

nity P

lann

ing P

art

ne

rsh

ip w

ill w

ork

with

co

mm

un

itie

s to

en

su

re th

at

citiz

en

s a

nd

oth

er

ke

y s

takeh

old

ers

in

Arg

yll

an

d B

ute

ha

ve

a

vo

ice

an

d a

re a

ble

to

influ

en

ce

th

e d

eve

lopm

en

t of

po

licie

s a

nd

str

ate

gie

s t

hat

will

aff

ect

the

ir liv

es.

info

rm th

e w

ay in

wh

ich

se

rvic

es in

Arg

yll

an

d B

ute

are

pla

nn

ed

and

de

live

red

.

info

rm th

e p

roce

ss t

hro

ugh

wh

ich

ch

an

ge

can

be

ach

ieve

d.

de

ve

lop

re

latio

nsh

ips a

nd

en

su

re th

at

ou

r com

mu

nic

atio

n is o

pen

an

d c

lea

r,

free

fro

m ja

rgo

n a

nd a

cce

ssib

le t

o a

ll.

The

Sco

ttis

h G

ove

rnm

en

t R

evie

w o

f C

om

mun

ity P

lan

nin

g,

Sta

tem

en

t of

Am

bitio

n p

ub

lish

ed

in

Ma

rch

20

12

ma

kes c

lea

r th

at

co

mm

un

itie

s h

ave

a k

ey r

ole

to

pla

y in

he

lpin

g t

o s

ha

pe

an

d c

o-p

rodu

ce

be

tte

r o

utc

om

es a

nd

th

at u

nlo

ckin

g th

at p

ote

ntia

l re

qu

ire

s

CP

Ps t

o h

ave

a s

tro

ng u

nde

rsta

nd

ing o

f co

mm

un

itie

s a

nd

to

pro

vid

e g

en

uin

e o

pp

ort

un

itie

s t

o c

on

su

lt, e

nga

ge

an

d in

vo

lve

th

em

.

To a

ch

ieve

th

is,

we

wa

nt

to w

ork

alo

ngsid

e a

nd

lis

ten

to o

ur

co

mm

un

itie

s b

y e

nab

ling c

om

mu

nitie

s t

o g

et

invo

lve

d in

ma

kin

g

se

rvic

es b

ett

er

an

d p

rovid

ing w

ays f

or

com

mun

itie

s t

o g

et

an

d e

xch

an

ge

info

rma

tion

. W

e w

an

t to

ba

se

ou

r a

ctio

ns o

n th

e p

rin

cip

les

of

co

-pro

du

ction

th

ere

by s

tre

ngth

en

ing c

om

mu

nitie

s a

nd

en

ha

ncin

g c

om

mu

nity r

esili

en

ce.

The

Com

mu

nity P

lann

ing P

art

ne

rsh

ip r

eco

gn

ise

s t

he

re

spo

nsib

ility

of

ea

ch

an

d e

ve

ry p

art

ne

r a

ge

ncy t

o a

ctive

ly e

nga

ge

with

co

mm

un

itie

s in

a m

ean

ingfu

l w

ay.

Th

is m

ea

ns e

nga

ge

me

nt a

t a

n e

arl

y s

tage

in

the

po

licy c

ycle

, su

pp

ort

an

d e

ncou

rage

men

t fo

r co

mm

un

ity r

ep

rese

nta

tive

s/s

take

ho

lde

rs a

nd

tra

inin

g a

nd

skill

de

ve

lop

men

t fo

r th

eir s

taff

.

Page 48 7.3i - Appendix 1

Page 95: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

���

�Wh

at

is c

om

mu

nit

y e

ng

ag

em

en

t?

Co

mm

un

ity e

nga

ge

men

t co

ve

rs m

an

y d

iffe

ren

t a

ctivitie

s c

arr

ied

ou

t w

ith

th

e p

eo

ple

wh

o m

ake

up

com

mu

nitie

s.

At

its c

ore

it is

a

bou

t m

akin

g s

ure

th

at p

eop

le c

an

pa

rtic

ipa

te in

lo

ts o

f d

iffe

rent

wa

ys t

o m

ake A

rgyll

an

d B

ute

a b

ett

er

pla

ce

to

liv

e,

wo

rk,

stu

dy

an

d p

lay.

Th

e P

art

ne

rsh

ip h

as a

do

pte

d th

e f

ollo

win

g d

efin

itio

n o

f com

mu

nity e

nga

ge

me

nt:

Co

mm

un

ity e

nga

ge

men

t is

the

pro

ce

ss o

f in

vo

lvin

g c

om

mu

nitie

s in

th

e d

eve

lop

me

nt a

nd

ma

na

gem

ent

of

se

rvic

es s

uch

as h

ea

lth,

ed

uca

tio

n a

nd

ho

usin

g.

It m

ay a

lso

in

vo

lve

oth

er

issu

es w

hic

h c

on

ce

rn u

s a

ll, o

r it m

ay b

e a

bou

t ta

cklin

g t

he

pro

ble

ms o

f a

n

eig

hb

ou

rho

od

, su

ch

as c

rim

e, d

rug m

isu

se o

r la

ck o

f p

lay f

acili

tie

s fo

r ch

ildre

n.

Co

mm

un

ity e

nga

ge

me

nt ta

ke

s m

an

y s

ha

pe

s a

nd

fo

rms. It

can

in

vo

lve

sim

ple

exe

rcis

es in

co

nsu

lta

tion

th

rou

gh

the

fo

rma

tion

of m

ulti-a

ge

ncy p

art

ne

rsh

ips w

ith

com

mu

nity

rep

rese

nta

tion

at th

e c

en

tre

. U

nd

erlyin

g e

ffe

ctive

co

mm

un

ity e

nga

ge

men

t is

th

e c

om

mitm

en

t of

se

rvic

e p

rovid

ers

an

d p

lann

ers

to

lis

ten

to t

ho

se

fo

r w

ho

m s

erv

ice

s a

re b

ein

g p

lan

ned

’. (

Co

mm

un

itie

s’ S

co

tlan

d,

Co

mm

un

ity E

nga

ge

men

t H

ow

to

Gu

ide

)

Typ

es

of

en

ga

ge

me

nt

Em

po

we

rme

nt

Invo

lve

me

nt

Co

nsu

ltatio

n

Co

mm

un

icatio

n

Info

rma

tion

Be

ne

fits

The

re a

re m

an

y b

enefits

th

at

can

be

ga

ine

d b

y b

oth

pa

rtn

er

org

an

isa

tio

ns a

nd b

y c

itiz

en

s.

The

fo

llow

ing c

an

be

ach

ieve

d b

y

liste

nin

g t

o a

nd

wo

rkin

g w

ith

co

mm

un

itie

s:

Pla

n a

nd

pro

vid

e s

uitab

le a

nd

lo

ca

lise

d s

erv

ice

s t

ha

t a

re t

ailo

red

to th

e n

ee

ds o

f th

e c

om

mu

nity

Em

po

we

r p

eo

ple

to d

efine

th

e v

isio

n f

or

the

ir o

wn

co

mm

un

ity

Pro

vid

e info

rma

tio

n a

nd

opp

ort

un

itie

s fo

r th

e p

ub

lic to

be b

ett

er

info

rme

d

Mo

nito

r &

mea

su

re p

erf

orm

an

ce

En

co

ura

ge

lo

ca

l pe

op

le t

o b

eco

me

active

ly in

vo

lve

d in

th

e d

em

ocra

tic p

roce

ss

Bu

ild o

n ‘re

sp

on

sib

le c

itiz

en

sh

ip’, c

ohe

siv

e c

om

mu

nitie

s w

ith

a s

ha

red

se

nse

of fa

irne

ss a

nd

so

cia

l re

sp

on

sib

ility

.

Page 49 7.3i - Appendix 1

Page 96: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

��

Imp

rove

s r

ela

tio

nsh

ip b

etw

ee

n p

art

ne

r a

ge

ncie

s a

nd

the

pu

blic

Bu

ild c

ap

acity

Ex

isti

ng

Mec

ha

nis

ms f

or

Co

mm

un

ity E

ng

ag

em

en

t

With

in th

e A

rgyll

an

d B

ute

Com

mu

nity P

lan

nin

g P

art

ne

rsh

ip,

the

re a

re m

an

y e

xa

mp

les o

f en

ga

ge

me

nt

activity t

akin

g p

lace

an

d a

re

wo

rkin

g t

ow

ard

s A

rgyll

an

d B

ute

Com

mu

nity P

lan

nin

g P

art

ne

rsh

ip o

bje

ctive

s.

Th

e C

PP

re

ce

ntly d

eve

lop

ed its

Be

tte

r C

om

mun

ity

En

ga

ge

men

t R

eso

urc

e P

ack a

nd

som

e o

f th

e c

om

mun

ity e

nga

ge

men

t an

d e

va

lua

tio

n e

xe

rcis

es a

re a

va

ilab

le o

nlin

e

( htt

p://w

ww

.arg

yll-

bu

te.g

ov.u

k/c

om

mu

nity-life

-an

d-le

isu

re/c

om

mu

nityd

eve

lop

me

nt )

. In

ad

ditio

n, a

nu

mb

er

of

ph

ysic

al re

so

urc

es a

re

ava

ilab

le o

n lo

an t

o C

PP

pa

rtn

ers

to

assis

t en

ga

ge

me

nt

activitie

s. T

he

se

ca

n b

e fo

un

d o

nlin

e a

t h

ttp

://w

ww

.arg

yll-

b

ute

.go

v.u

k/m

otiva

tin

g-y

ou

r-co

mm

un

ity),

or

ca

n b

e b

oo

ked

fro

m th

e C

ou

ncil’

s C

om

mu

nity D

eve

lop

men

t te

am

at

co

mm

un

ityd

eve

lop

men

t@a

rgyll-

bu

te.g

ov.u

k. W

hile

th

e lis

t b

elo

w m

ay n

ot

be

exh

au

stive

, it d

oe

s s

ugge

st

that

the

re is a

ran

ge

and

d

ive

rsity t

ha

t giv

es c

itiz

en

s a

nd

oth

er

sta

ke

ho

lde

rs a

n o

pp

ort

un

ity t

o fe

el th

at

the

ir v

iew

s a

re g

ath

ere

d b

y v

ario

us p

rovid

ers

of

se

rvic

es.

Are

a C

om

mu

nity P

lann

ing G

rou

ps

Citiz

en

s’ P

an

el

Fo

cu

s G

rou

ps

Th

ird

Se

cto

r A

rea F

oru

m

Mu

lti-a

ge

ncy P

art

ne

rsh

ip G

roup

s in

clu

din

g loca

l p

eo

ple

Co

mm

un

ity C

are

Fo

rum

Yo

un

g S

co

t

Co

mm

un

ity H

ea

lth P

art

ne

rsh

ip -

Pa

tien

t In

vo

lve

me

nt A

ctivitie

s

Crim

e P

reve

ntio

n P

ane

ls

Co

mm

un

ity S

afe

ty P

art

ne

rsh

ips

Do

me

stic A

bu

se

Fo

rum

Fe

ed

ba

ck F

orm

s

Ele

cte

d M

em

be

rs’ S

urg

erie

s

NH

S P

ub

lic P

art

ne

rsh

ip F

oru

m

Co

mm

un

ity D

eve

lop

me

nt T

rusts

Co

mm

un

ity C

ou

ncils

Page 50 7.3i - Appendix 1

Page 97: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

��

3rd

Se

cto

r P

art

ne

rsh

ip

Ha

rd t

o R

ea

ch

Gro

up

s

It is im

po

rtan

t th

at

we

info

rm,

con

su

lt a

nd

in

vo

lve

all

se

cto

rs o

f th

e c

om

mun

ity w

ho

ma

y b

e a

ffe

cte

d b

y a

ctio

ns a

nd

de

cis

ion

ta

ke

n

by t

he

CP

P o

r a

ny o

f its p

art

ne

rs.

Un

less c

are

is t

ake

n w

e m

ay n

ot suff

icie

ntly c

ap

ture

th

e v

iew

s o

f im

po

rtan

t gro

up

s o

f pe

op

le

with

in o

ur

co

mm

un

ity.

Th

is in

clu

de

s h

ard

to

re

ach

gro

up

s s

uch

as d

isa

ble

d p

eop

le, m

igra

nt

wo

rke

rs,

gyp

sie

s a

nd

tra

ve

llers

, yo

un

g

pe

op

le a

nd

old

er

pe

op

le. T

hro

ugh

co

nsu

lta

tion

we

will

ask t

he

se

, a

nd

oth

er,

gro

up

s a

bo

ut h

ow

th

ey w

ou

ld lik

e u

s t

o e

nga

ge

with

th

em

. A

lso

, th

e lo

ca

tion

s w

he

re w

e e

nga

ge

, th

e b

uild

ings u

sed

, th

e s

up

po

rt p

rovid

ed

an

d w

ays o

f co

mm

un

ica

ting w

ill r

eco

gn

ise

th

e

co

nstr

ain

ts o

f liv

ing in

a r

ura

l a

rea

an

d ta

ke

in

to a

cco

un

t th

e d

iffe

ren

t ne

ed

s o

f th

ose

we

will

be

en

ga

gin

g w

ith

.

Imp

lem

en

tati

on

Co

mm

un

ity e

nga

ge

men

t is

at th

e h

ea

rt o

f com

mu

nity p

lann

ing in

Arg

yll

an

d B

ute

an

d w

e a

s a

pa

rtn

ers

hip

com

mit t

o e

nsu

rin

g t

ha

t it

is a

drivin

g f

orc

e fo

r d

eliv

eri

ng im

pro

ve

d o

utc

om

es t

hro

ugh

ou

t th

e a

rea

. T

he

Action

Pla

n tha

t is

be

ing d

eve

lop

ed

as a

re

su

lt o

f co

nsu

lta

tio

n r

esp

on

se

s t

o th

e n

ew

Co

mm

un

ity E

nga

ge

men

t S

tra

tegy w

ill f

orm

the

ba

sis

fo

r th

e p

art

ne

rsh

ip t

o d

eliv

er

on

th

is

co

mm

itm

en

t w

ith

all

part

ne

rs c

ontr

ibu

tin

g o

utc

om

es f

rom

the

ir o

wn

co

nsu

lta

tio

ns a

nd

en

ga

ge

me

nt to

pro

du

ce

fo

rwa

rd lo

okin

g

actio

n p

lan

s.

Page 51 7.3i - Appendix 1

Page 98: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

���

�RE

SO

UR

CE

S,

PA

RT

NE

RS

HIP

WO

RK

ING

AN

D G

OV

ER

NA

NC

E

The

Arg

yll

an

d B

ute

Co

mm

un

ity P

lan

nin

g P

art

ne

rsh

ip h

as a

n a

nnu

al b

ud

ge

t of

ap

pro

xim

ate

ly £

50

0m

pe

r a

nn

um

fo

r se

rvic

es t

o t

he

p

eop

le o

f A

rgyll

an

d B

ute

.

The

pa

rtn

ers

hip

ha

s s

tre

ngth

ene

d o

ve

r its lifetim

e in r

esp

on

se

to

re

vie

w,

imp

rove

me

nt a

nd

on

go

ing c

ha

llen

ge

s tha

t th

e a

rea

fa

ce

s.

Str

on

g w

ork

ing r

ela

tio

nsh

ips a

nd

op

en

com

mu

nic

ation

are

fun

dam

en

tal to

the

eff

ective

ope

ratio

n o

f th

e p

art

ne

rsh

ip a

nd

th

e d

eliv

ery

of

ou

r o

utc

om

es.

The

Com

mu

nity P

lann

ing s

tru

ctu

re in A

rgyll

an

d B

ute

com

prise

s a

se

rie

s o

f le

ve

ls o

f in

tera

ctio

n, e

nga

ge

me

nt a

nd r

ep

resen

tation

. A

rgyll

an

d B

ute

Cou

ncil

ad

min

iste

rs t

he

pa

rtne

rsh

ip a

nd

pro

vid

es p

olit

ica

l re

pre

se

nta

tion

at b

oth

ma

na

ge

men

t a

nd

lo

ca

l a

rea

le

ve

ls.

The

Ch

air o

f th

e M

an

age

me

nt C

om

mitte

e r

ota

tes a

mo

ngst

pa

rtn

ers

on

a b

iann

ua

l b

asis

to

en

su

re a

cle

ar

pa

rtn

ers

hip

ow

ne

rsh

ip o

f th

e p

roce

ss.

The

Arg

yll

an

d B

ute

Co

mm

un

ity P

lan

nin

g P

art

ne

rsh

ip s

tru

ctu

re is illu

str

ate

d b

elo

w.

Th

is s

tru

ctu

re r

efle

cts

the

ge

ogra

ph

ica

l d

ive

rsity

of

the

are

a, e

nga

ge

men

t w

ith

ou

r com

mu

nitie

s,

the le

ad

ers

hip

and

acco

un

tab

ility

at

an a

rea

wid

e le

ve

l a

nd

re

co

gn

itio

n th

at th

e f

ull

pa

rtn

ers

hip

ha

s a

n im

po

rta

nt

str

ate

gic

ro

le in s

ha

pin

g t

he

dire

ctio

n o

ur

ou

tco

me

s a

nd

ou

r se

rvic

es.

Page 52 7.3i - Appendix 1

Page 99: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

���

Are

a C

om

mu

nit

y P

lan

nin

g G

rou

ps

Arg

yll

& B

ute

is a

la

rge

an

d d

ive

rse

are

a. C

om

mu

nitie

s c

an

ha

ve

diffe

ren

t is

su

es e

ve

n w

ith

in t

he o

ve

rall

um

bre

lla o

f a

co

mm

un

ity

pla

n a

nd

Sin

gle

Outc

om

e A

gre

em

en

t fo

r th

e w

ho

le a

rea

. It is im

po

rta

nt

tha

t th

ere

con

tin

ues t

o b

e e

ffe

ctive

go

ve

rna

nce

ove

r th

e

CP

P a

t a

lo

ca

l le

ve

l. I

t is

th

e r

ole

of

Are

a C

om

mu

nity P

lann

ing G

roups t

o d

isch

arg

e t

his

fu

nctio

n. T

he

ro

le o

f C

PP

Are

a C

om

mu

nity

Pla

nn

ing G

rou

ps is to

:

En

ga

ge

with

co

mm

un

itie

s t

o u

nde

rsta

nd

th

eir n

eed

s a

nd

re

qu

ire

me

nts

and

als

o t

o info

rm a

nd

con

su

lt o

n issue

s r

ela

tin

g t

o

the

CP

P a

t a

n a

rea le

ve

l.

En

su

re e

ffe

ctive

wo

rkin

g a

cro

ss c

om

mu

nity p

lan

nin

g p

art

ne

rs a

t a

n a

rea

le

ve

l.

En

su

re c

on

tinu

ou

s im

pro

ve

me

nt

in t

he

eff

ective

ne

ss o

f th

e C

PP

at

an

are

a le

ve

l.

Ma

na

ge

pe

rfo

rma

nce to

en

su

re d

eliv

ery

of

the

com

mu

nity p

lan

at an

are

a le

ve

l.

Are

a C

om

mu

nity P

lann

ing G

rou

ps m

ee

t fo

ur

tim

es a

ye

ar.

Page 53 7.3i - Appendix 1

Page 100: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

���

�Th

e M

an

ag

em

en

t C

om

mit

tee

En

su

rin

g t

he

re is e

ffe

ctive

en

ga

ge

me

nt, jo

int w

ork

ing,

po

licy d

eve

lop

men

t, p

lann

ing a

nd

prio

ritisa

tio

n a

nd

pe

rfo

rma

nce

m

ana

ge

me

nt

is a

ke

y r

ole

of

Co

mm

un

ity.

Th

is is t

he

ma

in f

ocu

s o

f th

e M

an

agem

en

t C

om

mitte

e. T

he r

ole

of

the

Ma

na

gem

ent

Co

mm

itte

e is t

o:

De

ve

lop

th

e C

om

mun

ity P

lan

an

d S

ingle

Outc

om

e A

gre

em

en

t to

se

t th

e o

ve

rall

dire

ctio

n fo

r co

mm

un

ity p

lan

nin

g p

art

ne

rs

in

Arg

yll

& B

ute

at a

str

ate

gic

le

ve

l.

Pe

rfo

rma

nce m

ana

ge

me

nt

with

an

acco

un

tab

le le

ad

id

en

tified

fo

r ea

ch

SO

A o

utc

om

e t

o e

nsu

re d

eliv

ery

of

the c

om

mun

ity

pla

n/S

OA

at

a s

tra

tegic

le

ve

l.

Re

po

rt p

erf

orm

an

ce

to t

he

pub

lic

De

ve

lop

po

licy a

cro

ss c

om

mun

ity p

lan

nin

g p

art

ne

rs th

at

su

pp

ort

the

de

live

ry o

f th

e C

om

mu

nity P

lan a

nd

Sin

gle

Ou

tcom

e

Agre

em

en

t at

a s

tra

tegic

le

ve

l.

En

ga

ge

with

co

mm

un

itie

s t

o u

nde

rsta

nd

th

eir n

eed

s a

nd

re

qu

ire

me

nts

and

als

o t

o info

rm a

nd

con

su

lt o

n issue

s r

ela

tin

g t

o

the

CP

P a

t a

str

ate

gic

le

ve

l.

Re

sp

ond

/re

act/

con

trib

ute

to

na

tion

al po

licy d

eve

lop

men

ts a

t a s

tra

tegic

le

ve

l.

Work

ing e

ffe

ctive

ly a

cro

ss c

om

mu

nity p

lann

ing p

art

ne

rs a

t a

str

ate

gic

le

ve

l.

Fa

cili

tate

th

e s

ha

rin

g o

f in

form

ation

be

twe

en

co

mm

un

ity p

lan

nin

g a

nd

str

ate

gic

pa

rtne

rsh

ips a

nd

id

en

tify

ing o

ppo

rtu

nitie

s fo

r im

pro

ve

d jo

int w

ork

ing.

Pro

mote

co

ntinu

ou

s im

pro

ve

me

nt

in th

e e

ffe

ctive

ne

ss o

f th

e C

PP

at a

str

ate

gic

le

ve

l.

The

Ma

na

ge

me

nt

Co

mm

itte

e m

eets

fou

r tim

es a

ye

ar.

Ch

ief

Off

ice

rs G

rou

p (

CO

G)

The

ro

le o

f th

e C

PP

CO

G is t

o:

En

su

re issue

s a

re b

ein

g r

ais

ed

and

actio

ned

on

be

ha

lf o

f th

e M

ana

ge

men

t co

mm

itte

e o

f th

e C

PP

En

su

re p

art

ne

rs a

re w

ork

ing e

ffic

ien

tly t

oge

the

r.

The

first

role

co

ve

rs a

ctio

n/s

up

po

rt t

o m

ake

rea

l/a

ction

/ope

ration

alis

e t

he

action

s a

nd

activitie

s a

gre

ed

by t

he

Man

age

me

nt

Co

mm

itte

e a

nd

th

ere

by t

o u

nde

rpin

eff

ective

de

live

ry o

f th

e c

om

mun

ity p

lan

. T

he

se

co

nd r

ole

re

late

s t

o c

ontin

uou

s im

pro

ve

me

nt

Page 54 7.3i - Appendix 1

Page 101: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

���

�ide

ntify

ing a

nd

ta

kin

g fo

rwa

rd o

pp

ort

un

itie

s for

co

llab

ora

tion

, jo

int

wo

rkin

g a

nd

sha

red

se

rvic

e a

t a

str

ate

gic

le

ve

l. T

his

wo

uld

a

dd

ress th

e f

ollo

win

g k

ey a

sp

ects

of

com

mu

nity p

lan

nin

g:

Eff

ective

wo

rkin

g a

cro

ss c

om

mun

ity p

lan

nin

g p

art

ne

rs.

Co

ntin

uo

us im

pro

ve

me

nt

in t

he

eff

ective

ne

ss o

f th

e C

PP

.

Pe

rfo

rma

nce m

ana

ge

me

nt

to e

nsu

re d

eliv

ery

of

the

co

mm

un

ity p

lan

The

Ch

ief

Off

ice

rs G

rou

p m

eets

fou

r tim

es a

ye

ar

with

th

e o

ption

to

co

nve

ne

ad

ditio

na

l m

ee

tin

gs a

s a

nd

wh

en

requ

ire

d.

SO

A D

eli

ve

rin

g O

utc

om

es

1-6

Ea

ch

of

the

six

te

n-y

ear

ou

tcom

es h

as a

n a

cco

un

tab

le le

ad o

ffic

er

wh

o is r

espo

nsib

le f

or:

Ide

ntify

ing t

he

re

leva

nt p

art

ne

rs t

o a

ch

ieve

the

outc

om

e.

Esta

blis

hin

g r

epo

rtin

g p

roto

co

ls w

ith

re

leva

nt p

art

ne

rs a

nd s

tra

tegic

pa

rtn

ers

hip

s.

Co

-ord

ina

te r

ele

va

nt

info

rmatio

n fo

r pe

rfo

rman

ce

ma

na

ge

me

nt p

urp

ose

s.

Qu

art

erly p

erf

orm

an

ce r

ep

ort

ing t

o M

an

agem

en

t C

om

mitte

e.

Str

ate

gic

Pa

rtn

ers

hip

s

The

re a

re a

la

rge

num

be

r of

str

ate

gic

pa

rtn

ers

hip

s a

cro

ss A

rgyll

an

d B

ute

th

at a

re a

lign

ed t

o p

art

icu

lar

po

licy a

nd

se

rvic

e a

rea

s.

The

se

pa

rtne

rsh

ips c

on

trib

ute

to

th

e d

eliv

ery

of

ou

tcom

es a

nd

are

an

essen

tia

l e

lem

en

t of

the

ove

rall

pa

rtn

ers

hip

ne

two

rk.

Th

ey

link in

to th

e o

ve

rall

CP

P s

tru

ctu

re t

hro

ugh

the o

utc

om

e le

ad

s a

nd

are

accou

nta

ble

fo

r se

rvic

e d

eliv

ery

an

d c

ontr

ibu

tio

n to

ou

tco

me

s

thro

ugh

th

e p

erf

orm

ance

ma

na

gem

en

t p

rocess.

Th

e F

ull

Pa

rtn

ers

hip

Re

sp

on

sib

ility

fo

r th

e o

ve

rall

de

ve

lop

me

nt

of co

mm

un

ity p

lan

nin

g in

Arg

yll

& B

ute

lie

s w

ith

th

e F

ull

pa

rtn

ers

hip

. It d

oe

s th

is b

y

de

lega

tin

g r

esp

on

sib

ility

fo

r in

div

idu

al a

sp

ects

of

com

mun

ity p

lan

nin

g t

o A

rea

Co

mm

un

ity P

lan

nin

g G

rou

ps,

Ma

na

ge

men

t C

om

mitte

e a

nd

CP

P C

hie

f O

ffic

ers

Gro

up

. T

he

activitie

s o

f th

e C

PP

ca

n b

e b

roke

n d

ow

n into

the

fo

llow

ing:

Str

ate

gic

ove

rsig

ht

of

co

mm

un

ity p

lan

nin

g.

De

ve

lop

ing t

he

Com

mu

nity P

lan

an

d S

ingle

Ou

tcom

e A

gre

em

en

t to

se

t th

e o

ve

rall

dire

ctio

n fo

r com

mu

nity p

lann

ing p

art

ne

rs

in A

rgyll

& B

ute

.

Page 55 7.3i - Appendix 1

Page 102: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

���

Po

licy d

eve

lop

men

t a

cro

ss c

om

mun

ity p

lan

nin

g p

art

ne

rs th

at

su

pp

ort

th

e d

eliv

ery

of

the

com

mu

nity p

lan

.

En

ga

gin

g w

ith

co

mm

un

itie

s t

o u

nd

ers

tan

d the

ir n

eed

s a

nd

re

qu

irem

ents

an

d a

lso

to

info

rm a

nd

co

nsu

lt o

n issu

es r

ela

tin

g t

o

the

CP

P.

Re

sp

ond

ing /

re

actin

g t

o n

atio

na

l p

olic

y d

eve

lop

me

nts

.

Eff

ective

wo

rkin

g a

cro

ss c

om

mun

ity p

lan

nin

g p

art

ne

rs.

Co

ntin

uo

us im

pro

ve

me

nt

in t

he

eff

ective

ne

ss o

f th

e C

PP

.

Pe

rfo

rma

nce m

ana

ge

me

nt

to e

nsu

re d

eliv

ery

of

the

co

mm

un

ity p

lan

.

Re

po

rtin

g p

erf

orm

an

ce t

o th

e p

ub

lic.

The

Fu

ll P

art

ne

rsh

ip o

f th

e C

PP

will

no

rma

lly m

eet

on

ce

ea

ch y

ea

r to

:

Re

vie

w t

he

ann

ua

l re

po

rt f

or

the

pre

vio

us y

ea

r.

Re

vie

w p

rogre

ss t

o d

ate

fo

r th

e c

urr

en

t ye

ar.

Se

t d

ire

ctio

n fo

r th

e n

ext

ye

ar.

Tim

e L

imit

ed

Gro

up

s

The

se

gro

up

s a

re c

om

ple

me

nte

d b

y T

ime

Lim

ite

d G

roup

s c

om

prisin

g r

ele

va

nt

CP

P p

art

ne

rs w

ith

a d

esig

na

ted

le

ad

. T

ime lim

ited

w

ork

ing g

rou

ps a

re f

orm

ed t

o a

dd

ress s

pe

cific

issu

es a

nd

ma

ke

re

co

mm

en

datio

ns to

th

e M

an

age

me

nt

Co

mm

itte

e,

Ch

ief

Off

ice

rs

Gro

up

an

d o

the

r str

ate

gic

pa

rtn

ers

hip

s.

Page 56 7.3i - Appendix 1

Page 103: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

7.3ii – Appendix 2

ARGYLL AND BUTE CPP: INITIAL FEEDBACK FROM QA TEAM Summary Narrative Still very much a work in progress, which requires significant ongoing development in a range of areas. As a result, it is difficult to form a cohesive judgement on the SOA at this stage. The draft benefits from a strong high level area profile which supports a clear set of specific challenges. Further understanding and analysis below that high level (by geography and with an emphasis on inequalities) would help shape and focus specific plans and interventions. There is at this point no clear alignment between these challenges and the CPP’s expression of priorities in its Long Term Outcomes. Nor does the draft SOA at this stage provide a sense about what impact the CPP expects to make on its priorities. Key Strengths • The “Understanding Argyll and Bute” section provides an informative area

profile, which helps to demonstrate an understanding of place. • Page 10 of the draft sets out a clear set of specific challenges for the Argyll

and Bute area. • Some positive features about Long Term Outcomes (e.g. attempt made to

set out 10 year horizons for outcomes, narrative of where Argyll and Bute is includes some reasonably honest assessments).

• A method for action (page 12), although at an early stage. Key Areas for Development • First and foremost, the CPP needs to complete its Plan for Place. Having

produced good work on understanding and demonstrating place specific challenges for Argyll and Bute, there then needs to be a clear line of sight between those challenges and the CPP’s priorities for the area (which are generic in nature).

• How the CPPs demonstrates that its Long Term Outcomes will inform local

resourcing decisions.

• Building in more place-specific 10 year visions for each outcome, to give a clearer sense of how Argyll and Bute will be different, especially in relation to its key challenges – i.e. the “impact” issue.

• Providing indicators and specific milestones (more outcome-based where

possible), so the scale of ambition and progress towards Long Term Outcomes can be assessed. This includes translating descriptive progress which the CPP expects to make in 3 years into realistic, measurable outcomes.

Page 104: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

7.3ii – Appendix 2

• Progress generally required on a range of fronts, including setting out plans for

each outcome, resourcing, community engagement plan and prevention plan. Suggested Themes for Discussion • How can the CPP demonstrate a clearer line of sight between its challenges and

its Long Term Outcomes, and how will the CPP ensure its Long Term Outcomes feed through into key activities?

• How can the CPP ensure and demonstrate that shifts in resources will be driven

in particular by its local and prevention priorities? • What plans does the CPP have to develop measurable indicators which give a

better sense of its expectations and progress towards its local and prevention priorities?

• What are the CPP’s plans, phasings and timescales for concluding work on the

elements of the SOA (e.g. plans for delivering outcomes, prevention and engagement) that are not yet in place? How will the CPP ensure that it can fulfil its other responsibilities effectively while the SOA is being finalised?

• What value does the Partnership expect to add to the individual contributions of

partners at strategic level, in driving and supporting the Long-Term Outcomes? • How is the CPP able to assure itself that it has the necessary leadership, and

governance and accountability arrangements, in practice to secure meaningful continuous improvement?

Page 105: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

7.3iii – Appendix 3

NHS Board Contribution to Community Planning Partn ership NHS Board: Highland Improving partnerships during 2013/14 Contributing to better outcomes through collaborative gain Argyll & Bute Community Planning Partnership In a similar way to Highland Community Planning Partnership, Argyll & Bute Community Planning Partnership has been reviewing structures, processes, performance management and governance. The previous SOA saw the CHP move to measuring performance through the Council Pyramid system and with the new SOA we will continue to be developing the focus on outcomes and their measures.

Page 106: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

Community Planning Partnerships: NHS Highland Summary of the key tangible contributions that the NHS Board will make during 2013/14 towards improved outcomes Clearly national improvements through HEAT and other programmes play an important role, however, this part of the LDP is expected to focus on locally developed improvements Strong emphasis on changes to NHS services which reduce future demand by preventing problems arising or dealing with them early on

Priority

NHS Board Contribution in 2013/14

Current and Planned Performance Levels

Economic recovery and growth

Healthy Working Lives for Highland and Argyll & Bute CPPs – the focus this year is on SMEs and on those employers where we can make most impact in terms of reducing health inequalities. By supporting employers to protect and improve the mental & physical health of their workforce, this initiative contributes to economic growth & recovery – by reducing sickness and other absence levels and supporting increased productivity; to employment – by promoting and supporting employability initiatives; and to reducing health inequalities - through targeting those employers where more than 30% of their workforce are earning low pay (defined as earning below the Living Wage).

Healthy Working Lives - KPI 1 Number of employers accessing our services KPI 2 Number of employers represented at training and awareness sessions. KPI 3 Number of employers supported in detecting health, safety and wellbeing issues to prepare an HWL action plan. KPI 4 Number of employers engaging with HWL services KPI 5 Number of employers supported in developing policies

Employment

A&B CPP Public Health staff involved in the regeneration plans for Inveraray, Rothesay and Dunoon Partnership working to increase the proportion of our young people going into positive destinations in Argyll & Bute.

Still to be determined by the CPP (timeframe for doing this June 2013) Still to be determined by the CPP (timeframe for doing this June 2013)

Page 107: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

Involvement in increasing public sector employment and training opportunities including work experience, graduate placement schemes, research etc.

Still to be determined by the CPP (timeframe for doing this June 2013)

Early years and early intervention

A&B CHP Working to ensure all babies experience the best possible pre and peri-natal environment Work with partners to ensure all children are developmentally ready to start to school. Support the development of parenting skills through targeted services. Work with partners to ensure children, young people and families at risk are safeguarded

Still to be determined by the CPP (timeframe for doing this June 2013)

Safer and stronger communities, and offending

A&B CHP All Looked After and Accomodated Children have a named Public Health Nurse with two main areas of responsibility (i) being the health partner to the child’s plan; (ii) ensure the health needs of all LAAC are met. Nurse Co-ordinators take responsibility to ensure public health nurses are aware of LAAC in their area and monitor the needs of young people in residential units, making sure there is effective co-ordination of their health plans Develop existing services for vulnerable pregnant women & babies and embed pre-birth assessment pathway Develop our responses to children affected by parental substance misuse and families involved in CPA.

Pre-birth assessment pathway implemented

Page 108: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

The new ADP Strategy has identified the following actions: • Ensure that parents are

identified during assessment by drug and alcohol services to embed GIRFEC guidelines in the Single Shared Assessment

• Develop local data on children affected by substance misuse

• Build strong links between the ADP and Children and Families Services to ensure shared policy and procedures for child protection

• Further research young people’s drinking patterns in Argyll & Bute to understand the reasons for the high level of alcohol consumption locally

• Further develop diversionary activities to support alternatives to substance use and to build capacity and resilience in young people

• Continue to work with vulnerable at risk groups of young people to support their needs and aspirations

Health inequalities and physical activity

The A&B CPP is considering the best way to structure emphasis on inequalities having previously had a specific plan and group focussing on it and latterly having it integrated throughout all work. The CHP will work with whatever the outcome of that deliberation. The CHP is currently working on implementation of Keep Well in areas and with groups that particularly experience

Page 109: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

health inequalities. As well as work already mentioned the CHP Committee is being asked to endorse increasing the work on physical activity in tandem with CPP partners. This will link with Keep Well and other initiatives. The CHP is also funding work on and evaluation of a physical activity scheme in Oban run by a social enterprise company which provides enhanced support for access to physical activity. Outcomes from this will help inform future work.

Older people

In A&B the CHP works with Argyll & Bute Council, Scottish Care, Argyll Voluntary Action and Argyll Carers Network on the Older Peoples Change Fund agenda. Their work has been nationally recognised and this programme of work extends into 13/14.

The specific outcomes are in the workstreams described from page 15 onwards in the attached document.

P:\Elaine Garman\A&B CHP - Shared\joint commissioning\JSNA\Meetings\2013\14 Jan\Argyll and Bute Change Plan.pdf

Page 110: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...
Page 111: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

7.3iv – Appendix 4

Health Workforce and

Performance Directorate

John Connaghan, Director

T: 0131-244 3480

E:

[email protected]

αβχδεφγηιϕ NHS Chief Executives Copied to NHS Chairs

___ 31 May 2013 Dear Colleague LOCAL DELIVERY PLAN NHS BOARD CONTRIBUTION TO COMMUNITY PLANNING PARTNERSHIP

The Statement of Ambition issued following the Review of Community Planning and Single Outcome Agreements made it clear that effective community planning arrangements are important strategic building blocks at the core of public service reform. NHS Boards are key partners within Community Planning Partnerships.

In this year’s LDP, NHS Boards were asked to include a concise summary of the key tangible contributions that will be made during 2013/14 towards improved outcomes in economic recovery and growth; employment; early years and early intervention; safer and stronger communities, and offending; health inequalities and physical activity; and older people.

There is increasing scrutiny on NHS Boards leadership in community planning and I would like to take this opportunity to thank those of you who will be working with public sector colleagues to quality assure SOAs.

We see this part of the LDP as a key tool for non-Executive and Executive Board members to exercise oversight. The draft LDPs set out a number of actions NHS Boards are taking, however we noted that, whilst summaries were not meant to be comprehensive, they did not always reflect key activity that we know is going on - this was true across all policy areas. In addition, NHS Boards will wish to reflect on the outcome of the quality assurance of SOAs in their area and in particular the key areas for development and/or improvement arising from the quality assurance process.

We expect that your Board will sign-off the LDP NHS Board Contribution to Community Planning Partnership before end of September and send a copy to the Scottish Government.

Page 112: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

St Andrew’s House, Regent Road, Edinburgh EH1 3DGwww.scotland.gov.uk αβχδε αβχ α

As set out in the LDP Guidance we will consider progress at this year’s mid-year stocktakes and next year’s Annual Review. At the mid-year stocktake we want to discuss how progress against the LDP NHS Board Contribution to Community Planning Partnership actions and other important work with CPPs is reported to your Board on an on-going basis.

Yours sincerely

JOHN CONNAGHAN

Director of Workforce and Performance

Page 113: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

Argyll & Bute CHP Committee 21 August 2013

Item No 8.1

FINANCE REPORT REPORT BY GEORGE MORRISON The CHP Committee is asked to; • Note the financial position at month 4 • Note the requirement for management action to achieve a year-end break-even position • Note the further challenges likely to be faced in 2014/15 arising from service improvements 1. Argyll & Bute CHP - Month 4 Financial Position For the four months ended 31st July 2013, Argyll & Bute CHP recorded an overspend of £274,000. This is an increase of £74,000 on the overspend reported at the end of June. Table 1 below provides details of budgetary performance across the CHP at month 4.

Table 1: Financial performance by budget at 31 st July 2013 Year to Date

Budget Annual Budget Budget Actual Variance

Forecast Outturn

£’000 £’000 £’000 £’000 £’000 Oban, Lorn & Isles Locality 18,942 6,250 6,508 (258) (311) Mid Argyll, Kintyre & Islay Locality 17,014 5,588 5,586 2 (94) Mental Health In-Patient Services 7,364 2,347 2,349 (2) 67 Cowal & Bute Locality 12,626 4,190 4,300 (110) (300) Helensburgh & Lomond Locality 4,884 1,628 1,581 47 50 Salaried Dental Service 4,300 1,231 1,231 0 0 Other Clinical Services 4,933 1,509 1,513 (4) 0 General Medical Services 15,422 5,006 5,120 (114) (150) Prescribing 17,077 5,536 5,506 30 0 Dental, Ophthalmic & Pharmacy 7,781 2,835 2,835 0 0 Services from NHS GG & C 49,437 16,148 16,163 (15) (46) Commissioned Services 4,074 1,339 1,382 (43) (437) Resource Transfer 4,658 1,553 1,553 0 0 Depreciation 3,300 1,112 1,112 0 0 Management & Corporate 7,924 2,542 2,535 7 0 Budget Reserves 1,300 150 0 150 400 Planned Management Action 0 0 0 0 800 Total Expenditure 181,036 58,964 59,274 (310) (21) Income (1,251) (450) (487) 36 21 Net Budget Position 179,785 58,514 58,788 (274) 0

The five main factors creating the overspend are;

• medical locum costs in Dunoon and Oban • nurse staffing costs in Ward B and A&E at Lorn & Islands Hospital • an overspend on the general medical services budget • an increase in individual care packages, especially referrals to Huntercombe • unachieved savings

Page 114: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

2

2. Budget Variance Analysis

The most significant budget variances are; Oban, Lorn & Isles Locality - overspent £258k Medical locums - £66k overspent due to a consultant physician vacancy. Surgical locums - £25k overspent due to annual leave cover. It is expected that this overspend will decrease as the year progresses. Ward B nursing pay costs - £59k overspent in due to sickness absence, maternity leave and special care nursing requirements. A&E nursing pay costs - £22k overspent due to sickness absence. Unachieved savings - £111k shortfall at month 4 reflecting a low declaration of achieved savings to date. Cowal & Bute Locality - overspent £110k Medical locums in Dunoon covering gaps in the casualty and out of hours rota - £99k overspent. Medical locums in Dunoon covering the hospital in-patient service - £31k overspent. Unachieved savings - £84k shortfall at month 4 reflecting 4/12ths of the locality's £252k target. No savings have been declared to date. General Medical Services - overspent £114k Locums covering vacant small practices and maternity leave - £72k overspent. Palliative Care enhanced service - £23k overspent due to payment of claims relating to 2012/13. Minor Surgery - £11k overspent due to an increase in claims. Seniority payments - £8k overspent due to an increase in claims. Commissioned Services – overspent £43k Two factors are contributing to an overspend on the commissioned services budget; increased charges from North Highland relating to acute activity, and in-patent admissions to Huntercombe. We currently have four patients in Huntercombe and at a monthly cost of £75,000 this has the potential to create a significant overspend on the budget if the patients remain there for several months, as seems likely. Greater Glasgow & Clyde SLA - overspent £15k The reported overspend relates specifically to increased activity at WestMARC which is a variable charge related to activity levels. It is assumed that the main patients services SLA will be settled in line with budget (£47m) however this is a significant financial risk to the CHP as GG&C claim a significant underpayment in the region of £5m. 3. Salaried Dental Service

Page 115: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

3

With regard to the Salaried Dental Service, it has been assumed that the service will be funded at cost and therefore a nil variance has been reported at month 4. A bid for funding of £4.3m has been with SGHD for several months now, however we are still awaiting confirmation of the level of funding that will be made available. 4. Cost Improvement Programme 2013/14 The CHPs savings plan for 2013/14 totals £2.4m. Savings in prescribing, commissioned services and depreciation look likely to be achieved. However the savings targets for Localities (totalling £1.05m) and management and corporate services remain challenging.

Table 2 below provides details of savings target performance.

Table 2: Argyll & Bute CHP Cost Improvement Plan 20 13/14

Recurring Savings Targets Responsible Manager

Target £' 000

DeclaredAchieved

£' 000 Outstanding

£’ 000

Forecast Achievement

£' 000

Likely Shortfall

£' 000 Oban, Lorn & Isles V Kennedy 365 31 334 200 165 Mid Argyll, Kintyre & Islay C West 331 89 242 271 60 Cowal & Bute V Smith 252 0 252 152 100 Helensburgh & Lomond V Smith 102 54 48 102 0 Unfunded Displaced Staff D Leslie 90 15 75 15 75 Prescribing F Thomson 1,000 687 313 1,000 0 Lead Nurse P Tyrell 20 0 20 20 0 Public Health E Garman 21 21 0 21 0 Management and Corporate D Leslie 76 0 76 76 0 Commissioned Services D Leslie 77 0 77 77 0 Depreciation G Morrison 66 66 0 66 0 Totals 2,400 963 1,437 2,000 400

A shortfall of £400k on the savings plan is currently forecast as some plans are not yet fully developed. Addressing this shortfall in the savings plan is included in the planned management action required to achieve a year-end break-even position. 5. 2013/14 Year-end Forecast Outturn Argyll & Bute CHP is currently forecasting a year-end break-even position, however this is dependent on management action to achieve this outturn. 6. Future Commitments As noted earlier in this paper, the CHP is finding it challenging to deliver savings in the current financial year. Looking ahead, funding uplifts for the next few years are likely to remain low and the financial challenge is likely to be unrelenting. A number of commitments have been identified that will require to be underwritten by efficiencies made elsewhere in the CHP.

Page 116: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

4

These include;

Table 3: Service Improvements to be Funded in 2014/ 15

Service £’000 Pain Relief Service 47 Point of Care Testing 70 Lead OT 13 Early Years Collaborative 42 Psychiatric Emergency Patient Transfer Service 100 Sustainable High Quality Healthcare in Remote Areas (potentially higher) 287 Pharmacy Data Analyst/Technician 19

Total 578

Whilst the need for these service improvements has been considered and acknowledged by the Core Team as necessary and indeed desirable, there implementation must be considered and contained within the limits of affordability and will be revisited and risk assessed as the financial position develops. George Morrison Head of Finance Argyll & Bute CHP 15th August 2013

Page 117: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

Argyll & Bute CHP Committee 21 August 2013

Item No : 9.1

PDP/R AND e-KSF IMPLEMENTATION 2013/14 Report by : David Logue, Head of HR 1. BACKGROUND AND SUMMARY The NHS Highland target for 2012/13 was that all Agenda for Change staff have a review against a Knowledge and Skills Framework (KSF) post outline, with at least 80% of reviews being carried out and recorded online using the web based system, e-KSF. At the end of year 2012/13 in the Argyll and Bute CHP 65% of all staff had a review completed, and 88% of permanent staff. This reflected positively against comparisons with other areas. All of NHS Highland is now in the position to be able state exactly the number of staff who have had reviews, that these follow the same process, and that staff are actively involved. This provides positive evidence to support how NHS Highland is addressing the national Staff Governance Standards. The ongoing target is likely to remain that 80% of all staff have a KSF review completed and recorded on e-KSF at least annually. 2. MONITORING PROGRESS 2013/14. The PDP&R programme has now moved towards ensuring a continuing high level of activity and National and Board wide monitoring is now focussing on a rolling level of activity over twelve month periods. This is shown in the two right hand columns of the table below. The position across NHS Highland at 30 June 2013 is as follows:

Area

All AfC staff

Reviews signed

off

% of AfC staff (all)

% of AfC staff (excl bank)

Reviews completed

within last 12 months

(excl bank)

% Reviews completed

within last 12 months

(excl bank) Argyll and Bute CHP 2031 76 3.74 5.05 1309 86.98 Corporate Services 717 65 9.07 9.27 463 66.05 West 922 62 6.72 9.38 516 78.06 Mid Highland 451 14 3.10 4.40 260 81.76 North Highland 962 39 3.41 4.97 475 72.30 Raigmore Hospital 3296 112 2.91 3.79 1840 72.78 South Highland 757 21 1.97 2.52 408 69.15

Note : Extract from eKSF-30.6-13 At 30.6.2013 the CHP currently had 3.74% of all staff (5.05% excl bank) with reviews and personal development plans signed off in e-KSF for this year so far. The total percentage for NHS Highland is 3.98% (5.16% excl bank posts).

The CHP Committee is asked to:

• Note the position In June 2013 • Note the trend to embed this in practice and use to support and direct staff

development in line with CHP and NHS Highland objectives • Note the need to ensure bank staff have review • Note the actions in place to maintain and improve progress.

Page 118: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

:

2 Sally Munro Workforce Development Facilitator 09-08-13

Over the preceding 12 months 86.98% of CHP substantive staff completed a review. 3. ACTIONS FOR 2013/14 In order to maintain progress and improve the proportion of staff that have an annual review, there will be a focus in 2013/14 on the following :

• Continue to addressing issues of missing data re a number of staff, particularly Bank, who do not have one or more of the following: named manager, e-mail address, no KSF outline or no review.

• Local managers and team leads planning and spreading reviews throughout the year

• The Workforce Development Facilitator will undertake a quality review through meetings

with local management forums and by asking members of A&B CHP Partnership Forum to complete a short survey questionnaire. This feedback will then be used to identify ways to improve and develop the quality of the programme.

4. NATIONAL SUPPORT ACTIVITIES New resources which have been recently developed by NHS Scotland in collaboration with NES and WEA (Workers Education Association) are now available on line:

• An internet based site has been developed specifically for KSF titled KSF Guidance; the site covers all aspects of KSF and the PDP&R process and contains links to key policy documents, (NHS Scotland Quality Strategy, PDP&R PIN Policy, Staff Governance Standards).The site details are www.ksf.scot.nhs.uk

• A PDP&R resource is now available on The Knowledge Network (within the Learning

and CPD area); the resource hosts a series of filmed workshops and videos of staff describing their experience of KSF.

• An e-KSF Guidance Tool is now also available on The Knowledge Network (within the

Learning and CPD area); the resource provides information regarding all aspects of using e-KSF.

Local KSF training and guidance material will be reviewed to take advantage of and encompass the key functions of these new resources. 5. QUALITATIVE BENEFITS OF KSF Regular development reviews and agreeing personal development plans support service quality, improvement, staff and clinical governance. Examples are:

• E-KSF is used to support redesign and service improvement processes by using the KSF

outlines to support staff in changing roles, and identifying differences in knowledge and skills required.

• The use of Foundation outlines for staff moving into new roles particularly as part of

service change/redesign should ensure supported development into these roles leading to more confident staff more efficient and effective services.

• The evidence is also being used as support for Continuous Professional Development

(CPD) and re-registration. In addition it allows for Mandatory and Statutory training to be included in every staff members’ PDP, which raises the profile and acts as a reminder and

Page 119: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

:

3 Sally Munro Workforce Development Facilitator 09-08-13

record enabling reporting of the levels of completion of required training across the organisation.

• This links directly to Professional leadership and registration and Health Care Support

Workers (HCSW) Standards to ensure public protection and maintenance of professional standards within our workforce.

6 CONTRIBUTION TO BOARD OBJECTIVES The achievement of the target is in line with the NHS Highland Board objectives. 7 GOVERNANCE IMPLICATIONS Staff Governance KSF and e-KSF are vital components of meeting Staff Governance standards. Patient focus and public involvement The KSF process enables performance management to assist with improved patient focus and public involvement where appropriate for roles. Clinical Governance KSF process provides the opportunity to monitor development activities of staff including clinical skills and ensures that staff develop and apply the appropriate knowledge and skills in order to be effective in their work. Financial Governance This is part of normal management processes. In addition, workforce costs are a large proportion of the allocated budget. KSF PDP/R and e-KSF support the effective use of staff, in particular through service change and redesign. 8. IMPACT ASSESSMENT The KSF and e-KSF processes are impact assessed at National level and will be monitored as part of overall staff engagement measures.

Page 120: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...
Page 121: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

ARGYLL & BUTE CHP

ARGYLL & BUTE CHP PARTNERSHIP FORUM

DRAFT MINUTE OF MEETING HELD

4th July in Aros Boardroom

Present: Dawn Gillies (DG) Unison (Co-Chair) Elizabeth McMillan (EM) Unison (Co Chair) Alastair Craig (AC) Senior Management Accountant Colin Crawford (CC) British Dental Association Veronica Kennedy (VK) Acting Locality Manager OLI Gaye Boyd (GB) Personnel Manager Pay Tyrrell (PT) CHP Lead Nurse Derek Leslie (DLe) Director of Operations Co-Chair Helen Duthie (HD) Unison Fiona Campbell (FC) Clinical Governance Manager By VC Lorna Low (LL) Royal College of Midwives Sally Munro (SM) Workforce Development Facilitator Pauline Murty (PM) Acting Hotel Services Manager Apologies : Viv Hamilton (VH) Locality Manager B &C and H & L David Logue (DLo) Head of HR Barbara McGilp (BM) Society of Radiographers Angela Dewsnap (AD) Personnel Officer Douglas Niven (DN) Unison Kate McAulay (KM) Clinical Service Manager MAKI Mark Middleton (MM) Risk/Heath & Safety Manager Bill Staley (BS) Information & Projects Manager John Dreghorn (JD) Mental Health Project Director - Mental Health Modernisation George Morrison (GM) Head of Finance Fiona Broderick (FB) Unite Christina West (CW) Locality Manager MAKI Stephen Whiston (SW) Head of Planning, Contracting and Performance Elizabeth Cowan (EC) Royal College of Nurses Linda Skrastin (LS) Clinical Services Manager H& L Moira Gillies (MG) Assistant Locality Manager Julian Gasgoigne (JG) Risk/Health & Safety Manager, Clinical Governance & Health & Safety Team Minutes: Rose MacVicar (RM) HR & Planning Contracting & Performance

Subject Action 1. Welcome and introductions

EM welcomed all to the meeting and asked all present for introductions.

2 Mins of meeting 16 th May 2013. Accepted.

Page 122: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

2

Subject Action 3 Matters arising

a) Datix As DLo was unable to attend the meeting today it was agreed that the item will be carried forward to the next meeting of the group on 15th August.

b) Text availability of shifts

VK advised issue of text messages has been discussed at bank staff meetings. VK has had no further feedback but understands the situation has been addressed.

c) X Ray Out of Hours VK advised that the Options Appraisal Non Financial Benefit workshop was held on 13th June and Optional Appraisal Risk workshop on the 14th June. An Options Appraisal paper was circulated but as this is the first stage of the process the report is confidential. Next Options Appraisal meetings are to be held on 29th August and 2nd September. Action carried forward that SW will table report on the above at a future Partnership Forum meeting.

d) Highland Partnership Forum

As requested DLo circulated previous minutes of the meeting. e) HCSW

SM advised that a further open day was held recently for bank staff. Unfortunately only 5 bank staff attended although those in attendance were very keen and positive. If other events are to be organised localities must ensure:-

� events are advertised widely e.g. displayed on information boards. � bank staff are aware what information will be available � possible use of text messaging to invite/remind bank staff of the event.

It was noted that events should incorporate all bank staff. Payment for attendance at the events will have to be agreed by Locality Managers.

f) RCOP – Dental Care

The issue was discussed at the local meeting of the RCOP. It was felt that, as this is an Argyll & Bute wide issue, it should be brought to the attention of Elizabeth Reilly (ER), Associate Clinical Director Dentistry who would be best placed to advise.

Copy of the minute of 16th May to be forwarded to ER for information/feedback.

g) Mileage/Travel

CC advised medical and dental staff have their own system in place for travel claims. It was also noted any changes to the rates will not affect lease car users. One scenario discussed was where a member of staff normally travels 20 miles to work has to travel 15 miles from home to meeting/home visit elsewhere. Under the system it would mean they cannot claim for this journey.

DLo SW RM

Page 123: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

3

Subject Action 3 Matters arising

g) Mileage/Travel continued Issue of the 5 unused miles was discussed. Concerns were raised that this could be deducted from the next journey claim. It was felt that this and other issues regarding travel claims may be of concern to staff and would require to be clarified. To ensure that all issues relating to travel claims are addressed it was agreed that the Partnership Forum members be contacted for comment. Points raised will be collated and raised at the next Partnership Forum meeting in August.

It was noted that an email had been distributed to all NHS Highland staff giving details of reimbursement of employee business travel costs. It was agreed that it might be helpful to re-circulate the email for information. It was also noted staff who are redeployed have protection on their excess travel costs for a period of 4 years. (Mileage paid is based on public transport rates.)

h) Pecos VK advised OLI has been able to identify some savings on stationery items etc using the Pecos system. It was noted Pecos is to be rolled out to all areas in the near future. VK advised dental admin staff had been trained on the use of Pecos and, if required, further training sessions can be arranged. CC stated translating orders from the catalogues used to Pecos can be time consuming. CC is of the view that details on the prices and differing quality of items are insufficient.

DG/RM GB/FC/ RM

4 Update on Children’s Services a) Argyll & Bute Children’s Services Inspection.

� PT reaffirmed content of DLe’s report tabled at the meeting on 16th May.

Additional areas of concerns were highlighted regarding the support for children/young people who

- have parents with Addiction issues - are receiving support from Mental Health Services.

Steps must be taken to ensure any possible gaps in services are addressed to ensure smooth transition for the young person from child to adult services. PT advised that actions/guidance arising from the above will be fed into the Integrated Children Service Plan.

b) Improving The Public’s Health In Scotland

PT advised the Scottish Government are conducting a review of the workload/role of Nurses, Midwives and Health Visitors. It is acknowledged that they have an important contribution to make in improving public health but that contribution needs to be considered alongside those of Social Work, Education etc. The purpose of the review is to maximise the effectiveness of services, to build upon existing strengths and to ensure co-ordinated systematic approach to improving the public’s health.

Page 124: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

4

Subject Action

4 Update on Children’s services b) Improving The Public’s Health In Scotland contin ued

It was noted that the current Public Health Nurse posts are to be redesigned with the reintroduction of Health Visitors posts working with children aged 0 – 5 years and School Nurses working with children/young people aged 5 – 19 years.

Copy of the paper will be forwarded for circulation to the Partnership Forum

c) Review and redesign of Campbeltown Nursing staff

PT advised the proposals for the redesign of the Campbeltown Nursing staff were agreed at the last Core Team meeting.

PT/RM

5 Finance Report AC presented an overview of the Finance Report (copy of the report was circulated prior to meeting). The report confirmed the CHP financial position as at 31st May 2013. It was noted that:-

a) the Budget is currently showing slight overspends, most of which are caused by use of locum medical staff though it was noted that planned management action is in place to bring the budget back in line with targets.

b) the underspend in MAKI budget is mainly through the underspend in

Campbeltown Hospital nursing posts.

c) SLAs with G G & C for patient services will be settled in line with the budget.

d) the budget for salaried dental service is now shown separately. AC advised the CHP are awaiting confirmation on the budget allocation from the Scottish Government.

CC advised that pressures will be placed on services if there is a reduction in budget for locum dentists.

Though savings targets are challenging for the localities, the managers are encouraged to continue to identify areas where cost savings can be made without impacting on services. The cost improvement programme savings plan for 2013/14 has identified areas where budget targets look likely to be achieved. Reporting forecast year-end break even position however this is contingent on management action to deliver improvements. VK advised NHS Highland are participating in the pilot of Scottish Government National Procurement. Members of the team met with managers to look at all supplies, contracts costs, what is good value for money and what can be negotiated. Possible budget savings could be achieved if the CHP were permitted to commission and negotiate services rather than through the current SLAs with G G & C.

6 & 7

Mental Health Modernisation Update Argyll &Bute CHP Committee Agenda items were moved down agenda to accommodate DLe delayed arrival at the Partnership Forum.

Page 125: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

5

Subject Action

8 Highland Partnership Forum a) DG advised that discussions were held on whistle blowing workshops.

It was noted that the confidential contact for Argyll & Bute has left the service. Views expressed were that confidential contacts are an important resource and play a vital role within the CHP. It was agreed appropriate steps to be taken to identify suitable replacement(s). Item to be included as an agenda item at the next meeting.

b) The Cabinet Secretary for Health and Wellbeing Ministerial will conduct a review in Highland on 19th July. This review will include looking at staff engagement.

Co-Chairs /RM

9 HR Update a) PDR and e-KSF

SM presented an overview of the paper on PDR and eKSF (copy of which was circulated prior to the meeting). As this is the start of the reporting process for year 2013-14 completion figures shown are relatively small. In order to ensure progress on meeting the proposed targets, actions will continue to address issues raised regarding email addresses, named managers etc. It is hoped that reviews are carried out over the year rather than the peak of activity occurring in February/March. For easier comparison, figures will be based on a rolling year rather than fiscal year. To accommodate this there will be a slight difference in the reporting process over the next few months. CC advised dental staff were experiencing difficulties in uploading data onto the database. SM advised that if documentation is required as revalidation for professional staff, where possible, paper copies should be retained by staff in their personal portfolios.

b) Learning and Development SM presented an overview of the first draft of the Workforce Development Plan 2013 /14 – Learning and Development (copies of the paper were circulated prior to the meeting) The main function of the group is to encourage and support learning and development in all staff groups across the A & B CHP in line with service plans at NHS Highland and CHP level. No points were raised on the document.

c) Staff survey Attention was drawn to the email sent to all NHS Highland users to encourage completion of the staff survey.

It was noted that paper copies of the survey were circulated via HR to the localities to enable completion by staff who do not have access to computers. Closing date for completion is 5th July SM advised Staff Survey 2010 is a subgroup of Partnership Forum. Minutes of the last meeting have been circulated for approval. Thereafter anything outstanding will be dealt with through PF.

Page 126: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

6

Subject Action

9 HR update d) Stress at work

Following analysis of the previous survey concerns were noted regarding the numbers of staff recording stress. As an action focus groups were formed in each of the localities.

It was acknowledged that work has been carried out to reduce stress at all levels but it was felt updated information/feedback is required in order to get a clearer picture and to ensure links with the Healthy Living agenda. It was agreed that the information from the local focus groups be collated and feedback to be tabled at the next meeting.

c) Redeployment

As requested at the last meeting of the Partnership Meeting GB presented an overview of the redeployment paper (copy of the paper was circulated prior to the meeting). An overall reduction in the figures was noted.

GB advised a concerted drive will take place to identify posts for staff on the Secondary Register. It was noted staff may be under the impression that, as they are already in post, it is not necessary for them to apply for alternative posts. GB stated HR are required to advise staff, on this register, of suitable vacancies at the appropriate grade that would meet the level of their protected earnings.

FC

At this point PT left the meeting and DLe joined the meeting.

10 Mental Health redesign As JD was unable to attend the meeting Dle presented an overview of the Mental Health redesign paper which was submitted to the CHP Committee in June.

a) Discussions are ongoing regarding the capital process. Key decisions will be made in the near future with regard to bundling the proposed new build with another capital project which will enable the project to continue to progress. A review of the expected capital project costs for 2013/14 will take place after decisions are made regarding bundling options.

b) Inpatient Services

The bed compliment remains at 28 plus 3 minimal supervision places in the refurbished Firgrove building.

Upgrade works to Succoth are complete and the upgrade works in IPCU continue.

An event to celebrate 150 years of mental health services at Argyll & Bute Hospital took place on 29th May. A brass plaque to commemorate the occasion was unveiled by Mr Thomas Byrn, Chairman of Acumen.

c) Staff Redeployment Nothing new to report since the last update.

d) New Posts Nothing new to report since last meeting.

Page 127: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

7

Subject Action

10 Mental Health redesign

e) Supported Transfer of Detained Patients Progress continues to establish patient retrieval service based in Argyll & Bute Hospital. It is anticipated that the number of out of hours calls will be fairly small. Funds have been identified to supplement current levels of staff.

f) CMHS Team Base Both Kintyre and Dunoon CMHT bases are almost complete and staff will be moving into their bases in the near future.

g) Dental Services

It was noted that discussions are ongoing regarding impact on service provision and staff.

DLe will forward copy of the paper to RM for onward circulation to the Partnership Forum.

DLe/RM

11 Argyll & Bute CHP committee DLe presented an overview of the meeting held on 19th June.

a) Helensburgh & Lomond Out of Hours Nursing Servic e Discussions continue with GG & C in relation to the redesign of the Out of hours/overnight nursing service for patients in Helensburgh & Lomond.

b) Bereavement Strategy An action plan has been developed to assist in the delivery of bereavement care guidelines and the development of support which will comply with the “Shaping Bereavement Care – A Framework for Action CEL9 (2011).

c) Recylcing/Waste Regulations

Changes to waste regulations are the subject of a review of the CHP’s waste management processes. These include an extension of recycling requirements, potential changes to handling and transportation and infrastructure arrangements.

d) Delivery of Sustainable Remote & Rural Health & Social Care NHS Highland are awaiting Scottish Government Health Department approval to explore ways to address service provision in remote and rural areas.

e) Campbeltown Community Hospital Continuing Care B eds Members of the CHP management team and locality staff attended a meeting held on 13th May. Discussions were held in relation to closure of continuing care beds. Reassurance was provided that contingency plans are in place to cope with changes in demand for in-patient beds. The free space in the hospital will be reviewed by the redesign group to identify what local service development might be supported by the use of this additional space.

f) Substitute Prescribing

The views of the community were also discussed at the open meeting held in Campbeltown on 13th May.

Page 128: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

8

Subject Action

11 g) Building the Bridge Together An event to consider how we can work better together to enable older people to live long, healthy and fulfilling lives in Argyll & Bute was recently held in the Corran Halls, Oban. A report on the outcome of the event will be published in due course.

h) Volunteering Awards The annual Volunteer awards took place in Council Chambers, Kilmory on the 31st May. For the second year NHS Highland sponsored a “Health Volunteer Award” for individuals who volunteer in a health environment. This year we presented two awards, one to the winner and a second in the “highly commended” category.

12 Organisational change � Mid Argyll Kintyre and Islay

It was noted that the MAKI meeting had been cancelled. Full updated to be carried forward to the next Partnership Forum.

� Cowal & Bute, Helensburgh and Lomond

As VH was unable to attend the meeting a brief verbal overview of the up to date position was given by PM.

a) Catering

Bute is now complete -1 displaced staff member remains. Cowal now complete – 1 displaced staff member remains

b) Domestic redesign.

Bute was delayed in terms discussions and mapping for day service. Cowal domestic redesign is underway, letters have gone out to staff confirming new posts, any vacancies will be advertised.

c) Community Nursing Team Helensburgh

PM advised following the notification from NHS G G & C of the proposed termination of the SLA, a meeting has been arranged with to discuss the provision of overnight/OOhs Community Nursing care.

� Oban Lorn & Isles. VK presented an overview of the up to date position.

a) Medical records redesign

Have received a good response from adverts for the vacant posts.

b) Mull Developments are continuing regarding the redesign of the Mull team. A further update will be given at the next Forum meeting.

c) Integrated Equipment store It was noted that the David Ross, Estates Manager has tabled a paper for consideration by the CHP giving the outline proposal for a single integrated equipment store. Concerns have been raised regarding the possible impact on the workforce in Oban as this area has the highest number of staff employed in the equipment stores. Staff have voiced concerns regarding insufficient information on the proposed organisational change.

Page 129: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

9

Subject Action

12 d) Integrated Equipment Store continued

DG raised the following concerns :-

- possible delays in delivery of equipment from a central rather than a local base

- decrease in availability of equipment - is the proposed service cost effective

- have job descriptions been amended or devised It was agreed that further clarification is required on the points discussed. It was agreed that DLe contact DR. Item to be included in agenda for next meeting.

Dle Co-Chairs/ RM

13

CHP & Locality Management Organisational Change Gro up EM reported that the first meeting of this group had taken place on the 20th June 2013. The Action Notes from the meeting were circulated to the Forum. The Action Plan was noted and following discussion DLe agreed to discuss the actions with DLo and VH. The action points from this group to be included as a standing item on the agenda under “Organisational change”.

Action DLe to discuss with DLo and VH

14 AOCB a) Public Holiday in September.

Historically Argyll & Bute CHP public holidays are in line with the dates shown for G G & C and Argyll & Bute Council rather than NHS Highland. It was noted that 23rd September is scheduled as a public holiday in Argyll & Bute. On checking internet notifications on the G G & C and ABC websites it was confirmed the Public Holiday for ABC and G G & C will be taken on 30th September. Given the disparity it was agreed that :- - CHP will have to clarify the date of the Public Holiday - as the majority of visiting and local Consultants will already have clinics set up

consider what the consequences will be if the date is altered from 23rd to 30th or vice versa

- if date remains as 23rd September will this lead to reduced availability or impede access to services for both Mondays.

b) Digital Recording of minutes

GB advised that a Digital Recording system has been purchased by HR for use in meetings. Similar equipment is in use in North Highland and was used recently in a disciplinary meeting (with the staff members consent). The aim of the equipment is to aid accurate recordings of meetings. It was noted that a Protocol for use on the equipment has been tabled at the HR subgroup for approval. It was agreed that following approval by the HR Subgroup Partnership Forum that the equipment be used for recording discussions held.

c) Nurse Bank

AC advised the Agenda for Change terms and conditions have been amended to reflect a national agreement on the way in which bank/casual workers were paid during periods of annual leave.

DLo to advise and confirm

Page 130: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

10

Subject Action

12 AOCB c) Nurse Bank continued

Annual leave accrued within each financial year quarter must be taken in the following quarter. Where annual leave is not requested it will be allocated in the next quarter by the staff bank and the bank worker will not be allowed to work for the duration of the allocated annual leave.

No payment in lieu of annual leave will be permitted except where the bank/casual contract comes to an end and there is WTR entitlement is outstanding. AC advised staff may not be aware of their leave entitlement as they only work occasional shifts. There is also the issue of leave hours accrued in the previous year. It would appear that staff may not be able to claim remuneration or take this as leave as entitlement may have ceased as at 31st March. It was felt that a number of issues arising from the payments to bank staff need to be addressed. To aid discussions it was agreed that an invitation to join a future meeting be forwarded to Ann Williamson, Unified Bank. VK and AC were tasked to collate specific questions on payments to bank staff. Thereafter DLo will raise with NHS Highland.

VK/AC/ DLo

13 Meeting closed Date, time and venue of next meetings as follows:- 15th August 3rd October 14th November

All to be held in Aros Boardroom at 12.30 p.m. Please note there will be no meeting held in December. Dates for meeting in 2014 as follows 9th January 20th February 3rd April 15th May 26th June 14th August 25th September 6th November 18th December

All meetings to be held in Aros Boardroom commencing at 12.30 p.m.

Glossary HR Human Resources OLI Oban Lorn and Isles MAKI Mid Argyll Kintyre and Islay B &C Bute and Cowal H & L Helensburgh and Lomond CHP Community Health Partnership GG&C Greater Glasgow and Clyde ABC Argyll & Bute Council

Page 131: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

Argyll & Bute CHP Committee 21 August 2013 Item ; 11.1

Delayed Discharge Weekly Briefing

as at

01 August 2013

Page 132: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

Prepared by Anne Cameron Page 2

Contents

Comments & Current Position Page 3

Delayed Discharge Weekly Update Page 4/5

Comments on Current Position

Page 133: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

Prepared by Anne Cameron Page 3

Current Position at 01 August 2013

Total Delayed Discharges = 7 Over 2 weeks = 1* Ov er 4 weeks = 2, Under 2 weeks = 4* 3 clients Coded 9/51x (AWI cases), 1 client Coded 9/71X who are all exempted and 3 clients

Code 100 who are excluded as they are awaiting reprovisioning/recommissioning *The above data is being used for CHP purposes only. The over 2 week target is not due to

be implemented by Scottish Government until April 2014

Planned Discharges = Nil

MONTHLY CENSUS INFORMATION

Scottish Executive Delayed Discharge Targets for Argyll and Bute Partnership for the month of July Census are as follows:-

Over 4 weeks Target is 0 Actual is 0

1 new Delayed Discharge since 26 July 2013

Since 1 st May 2012 any new Delayed Discharges include patien ts delayed 3 days or less. ---------------

Out of Area Hospitals

Hospital

Delayed under 2 weeks

Delayed 2 – 4

weeks

Delayed over 4 weeks

AWI Code 9/51x

Exempt

Other Exempt codes

Excluded Code Recommissioning/

Reprovisioning

Vale of Leven 1 1 2 Western/Gartnavel 1

Southern General

1

-------------

A. 2 patients are delayed over 4 weeks 1 patient in Argyll & Bute hospital from Tarbert area waiting on care package to be implemented to allow discharge to their home whilst awaiting vacancy for sheltered housing. Currently no care providers have capacity to facilitate any service. 1 patient in Lorn& Isles hospital, Oban who is delayed waiting on a care package to be implemented to allow discharge home but there are no care providers with capacity to facilitate this. Patient has been offered and declined an interim carehome placement until home care provider has been sourced.

1 patient is delayed over 2 weeks

1 Oban patient has been assessed by health and SW as requiring residential care but patient adamant that they wish to return to their sheltered housing flat .Revised careplan being completed.

Page 134: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

Prepared by Anne Cameron Page 4

B. Code 9/51x. Adult with Incapacity cases (AWI).The numbers have remained at 3 within the CHP and the numbers have remained at 2 patients in an Out of Area hospital.

C. Code 100.

3 Patients in A&B hospital remain as delayed discharges under code 100 and 1 patient in Gartnavel Hospital, Glasgow. These patients are not included in the numbers and are only reported to the Scottish government on an anonymous basis.

D. Code 9/71X

1 Patient in Lorn & Isles Hospital, Oban is awaiting a vacancy in a local residential home, Consultant has stated that patient should only be moved to chosen carehome and an interim placement is not to be considered. 1 Patient from Oban area in Western/Gartnavel Hospital is awaiting a bed vacancy in Fort William area. Patient had been suggested an interim placement in Helensburgh area, but declined this. Consultant has stated the patient’s prognosis is poor and that Fort William placement is the best outcome for them.

Delayed Discharges Weekly Update as at 01 August 2013

Total Numbers 7 Over 2 weeks 1 Over 4 weeks 2

Under 4 weeks 4 Additions 5

Removals/Deaths 4 Exclusions and Exemptions 7

OUT OF AREA

Vale of Leven Hospital, Alexandria .= 4

1 Awaiting completion of Financial Assessment. (Delayed over 2 weeks) 1 Assessment in progress. 2 AWI patients Coded 9/51X who are exempt.

Western/Gartnavel Hospital = 1 Awaiting completion of Financial Assessment. (Delayed over 2 weeks)

Gartnavel Hospital, Glasgow = 1 Patient Excluded as Code 100 under recommissioning/reprovisioning

Page 135: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

Prepared by Anne Cameron Page 5

Hospital / Area

Total Number New Removals

Code 9/25X

Code 9/51x

Code 9/71X

Code 100

E12 Under care of GP

Planned Discharge

Argyll & Bute 1 3 Victoria, Bute 1 2 1 2 Campbeltown 1 1 Cowal 1 1 1 Islay & Jura 1 1 Mid Argyll 1 Glassary Ward – Mid Argyll Mull Community

Lorn & Isles, Oban 4 2 3 1

Total 7 5 4 3 1 3 5

• 7 clients in addition there are 7 exemptions / exc lusions • NB. Exemptions are clients coded 9/51x Adults with Incapacity and coded 9/71X

(Interim placement unreasonable) and Coded 9/25X (A waiting complex arrangements to be completed –in order to live in their own home .(Specialist facility)

• Exclusions are code 100 (re-commissioning /re-provi sioning) REMOVALS = 4

Mid Argyll = 1

Patient removed as a Delayed Discharge as now requires further Multi-Disciplinary Team meeting to determine a discharge policy. Meeting arranged for 7th August.

Lorn & Isles = 3 1 Patient discharged to Nursing carehome. 1 Patient removed as a Delayed Discharge as now requires further Multi-Disciplinary Team meeting to determine a discharge policy, date to be arranged. 1 Patient originally coded AWI as disagreement between Powers of Attorney as to best outcome for the patient. Disagreement now resolved and patient’s assessments now being finalised for nursing home placement.

Page 136: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...
Page 137: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

Argyll & Bute CHP Committee 21 August 2013 Item : 12 Modernisation of Mental Health Services Update Report (July 2013) (2) Report by John Dreghorn 1. Background

The following report provides an update on the implementation of the modernisation of mental health services in Argyll & Bute.

2. Progress Report

� Project Governance The Capital Project Board met on 21st June. Next meeting is on 16th August. The Programme Board is due to meet on13 September.

� Capital Project Stage 1 Approvals - The revised stage 1 report, which was submitted by hubco to NHS Highland in May, remains

with our external advisors, and has yet to be accepted or rejected. No further work is taking place on the OBC until the advisors report back. A new approvals timetable has yet to be agreed.

� Inpatient Services

The bed compliment remains at 28 plus 3 minimal supervision places in the refurbished Firgrove building. Upgrade works on the IPCU single rooms is due to commence within the next few weeks which will result in a temporary reduction to 4 beds and a permanent reduction to 5. Occupational Therapy toilets and DSR refurbishment is complete as is the Physiotherapy department relocation which took place in June. Plans to relocate the MAPS/Clinical Psychology/OPD from the portakabin to Cowal Ward are being finalised and work should commence in August/September.

� Staff Redeployment Nil new to report since the last update.

� New Posts Nil new to report since last update

� Budget

Bridging: The bridging allocation for the project during 2013/14 remains unchanged at £500k as set by the CHP management team. We are currently reviewing the capital project funding requirements as we are anticipating a reduction in project management and advisor costs due to the slippage in the capital programme.

� Resettlement Group

Possibility of group home in the Oban area is being explored for 2 patients. In addition one of the places in Lochgilphead is likely to become available allowing another long term patient to move in. This will leave 2 long term/complex cases in the IPCU who require a resettlement plan.

� New Hospital Development � The Bundle: As reported in June it appears almost inevitable now that the new hospital project will not be considered viable as a stand alone project and will need to be bundled with another capital project from the North Scotland Hub area. As previously reported there are two projects; one in NHS Highland (Aviemore); and one in NHS Grampian (Inverurie) ; that appear to be of sufficient size and at a stage of development to meet the criteria to be consider as part of a bundle.

The meeting is asked to: � Note current key issues and progress against the action plan

Page 138: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

12 MH Services Modernisation Update Report July 2013 (2) 31/07/2013 J. Dreghorn Page 2 of 2

The need to bundle should be confirmed following the key stage review currently being undertaken by the Scottish Futures Trust (SFT). A decision on which project we will be bundled with should follow soon after that. At present it is unclear how much additional delay this will cause – but it is clear that both of the projects being considered for bundling are at an earlier stage of development, and that bundled projects need to have OBC and FBC approved, and achieve financial close, at the same time. It should also be noted that Crawford Cumming has now left the project. Crawford was appointed in May 2012 as the Capital Project Manager and has made a great contribution to developing the plans for the new hospital over the last year.

� CMHS Team Base Both Kintyre and Dunoon CMHS bases are complete. We await delivery of furniture and installation

of phones etc to allow them to become operational. In Campbeltown there are some discussions with the Kintyre & Islay Addictions Service regarding the best use of the shared space.

� Supported Transfer of Detained Patients The CHP Core team approved the proposal to recruit to a number of posts to support this development at end of June. The posts are currently out to advert. Those posts which will be recruited internally will be filled within the next few weeks, with external applicants being interviewed later in August.

� Recovery � 3 members of staff recently attended a one week Mental Health Recovery course at Boston

University. Teams from a number of countries attending the course which includes ongoing support from the University over the next 12 months for the teams to implement the principles of mental health recover in their area of work. The team (Gillian Davies, Moira Harrison, and Theresa Sinclair) have developed an action plan which will be presented at the next Programme Board for approval.

� Wellness Recovery Action Plans (WRAP)

Earlier this year 4 volunteers undertook training to become WRAP facilitators in Argyll & Bute. The volunteers included NHS staff, service users and an Acumen staff member. The group recently met with the 2 existing WRAP facilitators and began to develop plans to roll out awareness raising sessions and WRAP workshops across Argyll & Bute. The group is being supported and advised by John Moodie from the Scottish Recovery Network.

3. Summary

Uncertainty remains a significant feature of the Capital Project at present. We await advice from the external advisors and the outcome of the SFT key stage review. All the indications are that the project will be bundled, and that this will result in a further delay. The positive message from this though is the knowledge that other bundled projects have progressed beyond hub stage 1 and have benefited from the economies of scale that comes for being part of a larger combined capital project. A key focus for the wider MH modernisation project over the coming months is to roll out and embed “recovery” in all aspects of our work. The use of the SRI 2 tool will identify where we need to make improvements in practice in hospital and community. WRAP will help to ensure that we become more person centred; and the work led by the team that went to Boston will see the benefits of a recovery based values and principles service delivered for all patients. John Dreghorn Programme Director – Mental Health Modernisation

Page 139: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

Page 1 of 5

eHealth Department Aros Lochgilphead Argyll PA31 8LB

Minute of Meeting of the Argyll & Bute CHP eHealth Group

1 May 2013 JO5/JO7

J05/J07,Lochgilphead, Talisman Room, Helensburgh, LM office, Oban, & GG&C

Present: Pat Tyrrell, Chair John Dreghorn, Implementation Director, Mental Health Redesign

Dr John Lyon, Locality Clinical Director Dr Richard Sloan, MAKI Locality Representative

George Morrison, Head of Finance, (via VC) Kathleen Young, Medical Records Officer Kristin Gillies, Planning Manager Veronica Kennedy, Locality Manager Representative Ken Barr, Patient Representative, Dunoon Robin Wright, GG&C Representative (via VC) John McVey ICT Project & Liaison Manager Mary Wilson, AHP Lead (via VC) Derek Leslie, Director of Operations Bill Reid, Head of eHealth, NHS Highland James Brass, interim eHealth Manager Stephen Morrow, IT Development Manager Bill Staley, Information and Projects Manager In Attendance: Lhara Stevenson, PA (via VC) Item 1 Apologies Apologies were noted from the following:

Dr Michael Hall, Clinical Director Dr Grace Ferguson, Clinical Director/Consultant Psychiatrist Elizabeth Reilly, Community Dental Services Dr Brian McLachlan, Locality Clinical Director Item 2 Minute of Previous Meeting The minute of 7 November 2012 was accepted as a true record of the meeting, with the following changes to be made: - spelling correction page 1 & 2 of Elmmediate to elmmediate, page 4, Item 9, Manage to Manager. Item 3 Matters Arising

• Use of Internet: No blanket decision on banning personal use of internet, concerns remaining around network bandwidth issues. Managers asked to raise awareness of this issue with their own teams.

Page 140: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

Page 2 of 5

• ICNET discussions: James & Pat will take this item forward. • A&E System Update: Bill Staley carrying this action forward. • A&B Council Update: Bill will provide update at next meeting re his presentation on NHS

Highland/Highland Council integration experience Item 4 Activity Highlights/Management Report 4.1. eHealth Activity and Strategy Implementation Update James Brass/Stephen Morrow/Bill Staley spoke to the paper.

• OneSign/Single Sign: awaiting boxes being configured at Raigmore – technical issues/barriers. No set timescale.

• Migration to NHS Highland NHS Mail: Lochgilphead completion by end May, then onto Oban and remaining areas. Timescale for completion is November.

• 18 Week RTT/TTG: cancellation letters still in development. Using Helix & manually produced letters for informing patients. It is hoped that when Trakcare is implemented the issue will be resolved. Question raised as to Trakcare’s capacity to store A&B letter formats. James & Bill R will see if they can get some clarification on whether letter capacity on Trakcare is a limited. No breeches to date.

• Telecoms SLA Review: Timescale for project has slipped to June/July. James will clarify with GG&C/BT the site information they hold for us and compare that with the details Locality Managers pass to him re site phone lines. He will work with David Ross on the issue and update parties accordingly. A meeting is to be arranged between James, David Ross, & Veronica Kennedy re the Oban site. It was highlighted that letters sent to patients have contact numbers and should these numbers change notification to the relevant dept must be given asap in order to update patient letter templates. GG&C will likely review the SLA in light of the work they are carrying out in relation to this work.

• NHS Highland Data Repository: A successful meeting took place in April where the team from North Highland and the team from A&B met to discuss Data Repository in light of Trakcare. The teams agreed to a closer collaboration of working.

• Lab Links: Two thirds of Vision practices receiving lab results, all practices should be by July/August. Microbiology results not being received, not likely to be received in future due to a technical issue at GG&C. James will speak to GG&C about other possible options (ICE?).

• Pharmacy System: GG&C accepted ACRIBE arrangements as put forward by us. Ongoing discussions to be had with Janet Boyd.

• Healthcare in Police Custody Suite: Forensics is an issue still to be agreed upon.

James Brass & Pat to progress with ICNET.

Bill S to report back re MiDIS as a potential A&E system out with L&I.

Bill R to provide update on integration experience

James Brass & Bill R to seek clarification on Trakcare’s capability/capacity for storing letter templates.

James, Veronica & David Ross to meet to discuss telecom requirements at Oban site, James will feed this back to

GG&C/BT.

James to speak to GG&C re microbiology.

Page 141: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

Page 3 of 5

Item 5 Finance Report (i) Outturn for 2012/13: George gave an update. It was a successful year for eHealth there was

a departmental budget of £1.3m and this was under spent. The saving target of £35k was achieved. The £440K discretionary spend was fully utilised.

(ii) Plan for 2013/2014: James spoke to the paper. In particular he highlighted that there had been an update to Service Contracts (Chemocare) as per the paper. Iain Ross and James working on the capital bid for this year. The allocation costs of the National Strategy funding were highlighted and in particular a note that iSoft eIDL and ICNET are estimates only. Recurring costs to the schemes outlined are not anticipated.

Item 6 TrakCare implantation Update (i) Update from Project Board Bill Reid informed the group most Trakcare post have been recruited. A Project Executive Group is being established. At a recent Clinical Focus group meeting turnout by clinicians was very poor. Clinical and Administrative demos of Trakcare have and are taking place, however the Clinical demos are poorly attended. Therefore the question is how we get clinicians to engage willingly in the move and use of Trakcare. Derek commented that eHealth can deliver the implementation of the product but for the system to be a true success behavioural change by clinicians is needed. The paper for noting was updated in April and should be re-circulated to clinicians for comment. Pat suggested that Pat, Dr Michael Hall, and Mary could meet to discuss ways for better clinical involvement. The services of Deliotte are engaged to look at the relationship between NHS Scotland and Intersystems. There is a meeting scheduled in May and Bill R is nominating people to attend. Discussions are ongoing about the population of Trakcare from our current PAS systems. Hazel McPhail has been travelling around the localities providing demos on the Trakcare programme. Dr Sloan highlighted an issue about SCI referrals to GG&C when the referral is sent back to the GP for referral elsewhere. The GP is unaware this has happened unless the patient returns to the GP about a lack of hospital appointment or unless the GPs are pro-actively checking SCI Gateway. Bill S said he would investigate. The group was asked to note the demand on eHealth services in light of Trakcare using up a lot of resource.

The group approved the updated spending planning.

James to circulate the updated paper for noting – Patient Management System – A Clinicians View

Pat, Dr Michael Hall & Mary to meet to discuss ways for better clinical involvement.

Bill S to look into referral back to GP issue.

Page 142: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

Page 4 of 5

(ii) Implementation Update: Bill S spoke to the paper. He spoke through the 3 PAS technical stages- Infrastructure, Interfaces and Migration. There is a meeting on 17th May to discuss the amount of data requiring migration. Under the PAS Outpatient/Medical Records & PAS Inpatients section he informed the group that he has met with Brent Craig & Alison MacKay. Brent is the project lead for PAS Outpatients and MRO. Alison is the project lead for PAS inpatients. Bill the spoke through bullet points a-f of re other activity. A&B staff will be attending workshops in Inverness. It is not yet known if there is money in the Trakcare budget to pay for staff attendance at the workshops i.e. travel costs, overnight stays, backfill. It may well have to come from existing budgets within teams. This will be discussed at the Project Executive Group and Core Team Meetings. Kristin asked what processes are in places to ensure that everyone is prepared for the November implementation date. The Business Transformation group should look at the processes prior to November.

Item 7 MiDIS Update James spoke to the paper. He highlighted Tayside have moved the largest MiDIS boards onto discreet environments to isolate any detrimental instances bettering system stability. Under the heading Project Resourcing James wanted the group to note there may be a need for additional form building resources(short term). James informed the group that Tayside have moved to tablets in place of hand held devices but we are considering a combination of tablets & hand held/pens. This will be explored further in the coming months. Lochgilphead would be the first area to access Mental Health Services on MiDIS. The roll-out at Cowal should be complete June/July and based on the experience there rolled-out to other localities. Mary said she had money in her budget to help write the forms for the MF Tool. She would like to see her other AHP services added to MiDIS. Item 8 eIDL Discharge Letter James spoke to the paper. In March funding was agreed to support the work to have cross border sharing/configuration/training for all 33 GP practices. The link is not yet established but once in place letters are sent out from GG&C hub to the Highland hub and onto the GP practice. In the interim handwritten letters are scanned and delivered to the GP practices over NHS Mail. It has also been agreed that iSoft eIDL will be used in A&B, it may stay in use even after Trakcare implementation. The timescale for use of iSoft is dependent on the supplier. Some training on this system has already taken place and James will shortly be visiting Oban to run through the system. There is no guideline stipulating when a GP should receive the discharge letter from the hospital, potentially this could cause a continuity of care problems. Item 9 GG&C Update This item was spoke to at the opening of the meeting by Robin as he had to leave early. ICNET: asked James to contact Janet Boyd to progress. Mircotech: cross border sharing has been set up. Lablinks: GG&C consolidating. Project Manager in place and will touch base with James. Trakcare: Clinical portals will share information - import to see how we engage with clinical portals. Robin will pass to James the contact name & number of the GG&C person dealing with this aspect of the work. Contractual issues will not stand in the way of progress. Robin & Bill R to discuss Scottish government work issues. GG&C are focussing heavily on Trakcare for the next 4 wks and thereafter have more time to dedicate to us. Robin has invited A&B CHP to come and share the learning process surrounding Trakcare implementation. There is an Operational Review Group which A&B CHP should seek membership too.

Robin to pass James contact name & number of clinical portal person.

Robin & Bill R to meet re Scottish Government

Bill R/James to seek members to the Operational Review Group.

Page 143: ARGYLL & BUTE CHP Wednesday 21 August 2013 Lecture Room ...

Page 5 of 5

Item 10 A&B Council Update. John was welcomed to the group; John replaces Katrina on the group. He asked if there was anything in particular we wished to raise with him. He is aware of some bridging issues between the Council & NHSH networks and he plans to take this forward. As he had 1 days notice for the meeting he did not bring/submit any items to the meeting. Item 11 Paper for Noting As per previous discussions above. Item 12 Any Other Competent Business Bill S sought the group’s approval to write to a GP re SCI Gateway Internet Explorer default setting as raised by the GP. It was noted that the National view is that Internet Explorer be the default setting as this is the only browser tested on Gateway. The group approved Bill’s request to write to the GP informing him of this. Bill & James shall draft the letter together. 13. Date and Venue of Next Meeting: 14th August 10:30-13:00 hrs, JO5/JO7 MACHICC & Talisman Room, Helensburgh

Bill S to write to GP re Internet Explorer.